Reactive Balance Responses in Individuals with Lower Limb Amputation: A Scoping Review

Individuals with lower limb amputations (LLA) face a high fall risk, yet their reactive balance responses to unexpected perturbations remain poorly understood. This scoping review synthesized 16 studies comparing individuals with and without LLA during standing and walking perturbations. Across studies, people with LLA showed direction-dependent responses, relying heavily on the sound limb during anteroposterior challenges and demonstrating difficulty managing mediolateral perturbations due to limited prosthetic control. During walking, they used less effective strategies, such as trunk-dominant adjustments and hopping, especially when perturbations targeted the prosthetic limb. Overall, findings suggest that prosthetic mechanics shape balance responses, highlighting mediolateral stability as a key clinical priority.