{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T21:00:09Z","timestamp":1773435609864,"version":"3.50.1"},"reference-count":43,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objective: Postural control differs between individuals with lower limb amputation and the general population. Although previous studies examined the effects of unexpected surface perturbations on postural control in individuals with transtibial amputation (TTA) and individuals with transfemoral amputation (TFA), their impact on lower limb muscle activation remains unclear. This study aimed to assess postural control on a stable surface and to evaluate the effects of unexpected surface perturbations on lower limb muscle activation in unilateral TTAs, TFAs, and in a healthy control group (CG). Methods: The study included 10 TTAs, 9 TFAs, and 10 healthy controls. Postural control was assessed using a force platform, and lower limb muscle activity was recorded with surface electromyography during unexpected surface perturbations. Results: The TFAs showed the highest anteroposterior and lateral postural sway under compliant surface eyes closed and the highest lateral sway under normal surface eyes closed, whereas the CG showed the lowest values (p &lt; 0.05). During forward perturbations, rectus femoris (RF) and tibialis anterior (TA) activations were significantly higher than biceps femoris (BF) and medial head of the gastrocnemius (GM) activations, respectively, across all groups (p &lt; 0.05). During backward perturbations, GM activations exceeded TA activations in all groups, while BF activations were higher than RF only in TTAs (p &lt; 0.05). Significant group effects were found for RF and BF during forward perturbations, and side effects for BF (forward) and RF (backward) activations (p &lt; 0.05). Conclusions: Postural control responses vary with the level of lower limb amputation. TFAs relied more on visual input during quiet standing, whereas TTAs demonstrated greater reliance on thigh muscle activation during surface perturbations. These findings highlight the need to consider amputation level in balance and rehabilitation programs.<\/jats:p>","DOI":"10.3390\/jcm14248737","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T16:11:18Z","timestamp":1765383078000},"page":"8737","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Analysis of Standing Postural Control and Perturbation-Induced Muscle Activity in Transtibial and Transfemoral Amputees"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3582-8620","authenticated-orcid":false,"given":"Mustafa Cem","family":"T\u00fcrkmen","sequence":"first","affiliation":[{"name":"Department of Therapy and Rehabilitation, Disabled Care and Rehabilitation Program, Sabuncuo\u011flu Serafeddin Health Services Vocational School, Amasya University, 05100 Amasya, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9197-1974","authenticated-orcid":false,"given":"H\u00fcseyin","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Therapy and Rehabilitation, Physiotherapy Program, Sungurlu Vocational School, Hitit University, 19030 Corum, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-4535","authenticated-orcid":false,"given":"Ali \u0130mran","family":"Yal\u00e7\u0131n","sequence":"additional","affiliation":[{"name":"Movement Analysis Laboratory, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9090-3937","authenticated-orcid":false,"given":"Semra","family":"Topuz","sequence":"additional","affiliation":[{"name":"Movement Analysis Laboratory, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06800 Ankara, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0197-4580(01)00247-0","article-title":"Changing complexity in human behavior and physiology through aging and disease","volume":"23","author":"Vaillancourt","year":"2002","journal-title":"Neurobiol. 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