Development and validation of a protocol for comprehensive postural balance assessment in individuals with lower-limb immobilization under dual-task conditions

Aim. This paper aims to develop and substantiate a comprehensive protocol for the assessment of postural balance in persons with lower-limb immobilization under dual-task conditions. Materials and methods. The key study methods included the following: analysis, to justify the relationships between assessment procedures; synthesis, to generalize findings and establish the sequence and structure of the examination; and forecasting, to form the prerequisites for developing an assessment algorithm and a model. Results. The study resulted in a detailed protocol comprising four key assessment conditions for postural balance and the autonomic nervous system: 1. in a standing position; 2. during a battery of sensorimotor tests; 3. during treadmill walking; and 4. during walking while simultaneously performing sensorimotor tests. The protocol presumes a simultaneous recording of force platform measurements using an inertial sensor unit, electrocardiographic monitoring, and psychophysiological assessment. Special attention was paid to safety measures, subject inclusion and exclusion criteria, and the procedure for adaptation to immobilization. Conclusion. The proposed protocol provides a standardized monitoring algorithm and enhances the safety for participants and the reliability of the obtained data. A comprehensive analysis of gait patterns, postural balance, psychomotor functions, and autonomic regulation under dual-task conditions allows for revealing the specific features of the mechanisms of voluntary movement control. These findings are of practical importance for the optimization of rehabilitation programs for persons with musculoskeletal disorders, including lower-limb amputees.