Individualized task difficulty promotes balance training outcomes and self-efficacy in individuals with lower limb loss.

An ideal motor skill learning typically features adaptive task difficulty to facilitate training outcomes and avoid frustration, yet this concept has not been explored in balance training for individuals with diminished postural control including lower limb loss. The purposes of this study were (1)...

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Published in:Prosthetics & Orthotics International Vol. 50; no. 2; pp. 137 - 141
Main Authors: Wu, Fu-Lien, Chung, Yu-Chen, Lee, Szu-Ping
Format: research tables/charts randomized controlled trial Journal Article
Published: Lippincott Williams & Wilkins Apr2026
Online Access:View this record in EBSCOhost
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      dt: Apr2026
      vid: 50
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Individualized task difficulty promotes balance training outcomes and self-efficacy in individuals with lower limb loss.
      aug:
        au:
          Wu, Fu-Lien
          Chung, Yu-Chen
          Lee, Szu-Ping
        affil: Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, NV, USA
      sug:
        subj:
          Above-Knee Amputation Rehabilitation
          Below-Knee Amputation Rehabilitation
          Balance Training, Physical Equipment and Supplies
          Task Performance and Analysis
          Individualized Medicine
          Self-Efficacy Evaluation
          Treatment Outcomes
          Human
          Funding Source
          Amputees
          Male
          Female
          Middle Age
          Aged
          Weight-Bearing
          Feedback
          Balance, Postural Evaluation
          Motor Skills
          Limb Prosthesis
          Random Assignment
          Randomized Controlled Trials
          Unpaired T-Tests
          Repeated Measures
          Two-Way Analysis of Variance
          One-Way Analysis of Variance
          Post Hoc Analysis
          Data Analysis Software
          Adolescence
          Adult
          Middle Aged: 45-64 years
          Aged: 65+ years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Male
          Female
      ab: An ideal motor skill learning typically features adaptive task difficulty to facilitate training outcomes and avoid frustration, yet this concept has not been explored in balance training for individuals with diminished postural control including lower limb loss. The purposes of this study were (1) to examine a novel stabilometer-based task with individualized difficulty levels as a balance training protocol and (2) to compare the task performance and self-efficacy between participants receiving the training with and without individualized task difficulty. Ten older adults and 10 individuals with unilateral lower limb amputation were recruited. The experimental group received training with task difficulty individualized based on their pretraining weight-bearing capacities, whereas the control group received standard training without difficulty adjustment. Participants were instructed to maintain the stabilometer in a horizontal position for as long as possible over 20 trials (4 blocks, 30 s per trial). Performance feedback and task-related self-efficacy were assessed after each block. Participants in the 2 groups were comparable in age (62.1 vs. 63.5 years), gender composition (4 females), and amputation levels (3 with transfemoral amputation). Significant interactions between group and trial/block in time in balance (experimental group: 7.8 to 16.9 s, control: 8.5 to 8.2 s, P = 0.002), root-mean-square error (experimental group: 10.9° to 6.8°, control: 10.9° to 10.8°, P = 0.002), and self-efficacy (P = 0.005∼0.012) were detected. The training protocol with individualized difficulty levels promoted greater improvements in balance performance and self-efficacy. Individualizing task difficulty based on participant's capacity is important for improving balance performance and self-efficacy. This training protocol is feasible and can be applied clinically to improve balance and postural confidence in individuals with lower limb loss.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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