Can high-functioning amputees with state-of-the-art prosthetics walk normally? A kinematic and dynamic study of 40 individuals - 20/02/21
, Neil D. Reeves a, Martin Twiste b, c, Rhodri D. Phillip d, John Etherington d, Alexander N. Bennett d, e, f
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Highlights |
• | This is a comprehensive set of gait analysis data and descriptions of how individuals with amputation walk. |
• | It provides a thorough up-to-date description of how lower-limb amputation changes an individual's gait pattern. |
• | With current high-specification prosthetic provision and intensive rehabilitation, individuals with amputation can achieve a gait pattern very similar to able-bodied individuals. |
• | In light of limitations with current prosthetic design and discomfort from the socket, we cannot expect an individual with amputation(s) to walk exactly as able-bodied individuals. |
• | These results can be used as benchmark data to represent gait patterns of highly functional individuals with amputation to guide clinicians in what is possible. |
Abstract |
Background |
Previous work has highlighted the highly functional post-rehabilitation level of military individuals who sustained traumatic amputation. Understanding how these individuals walk with their prosthesis could be key to setting a precedent for what is realistically possible in the rehabilitation of individuals with amputations.
Objective |
The aim of this paper is to answer how “normal” should the gait of an individual with an amputation(s) be and can we aspire to mimic able-bodied gait with the most advanced prosthetics in highly functioning individuals?
Methods |
This was a cross-sectional study comparing the gait of severely injured and highly functional UK trans-tibial (n=10), trans-femoral (n=10) and bilateral trans-femoral (n=10) military amputees after completion of their rehabilitation programme to that of able-bodied controls (n=10). Joint kinematics and kinetics of the pelvis, hip, knee and ankle were measured with 3-D gait analysis during 5min of walking on level ground at a self-selected speed. Peak angle, moment or range of motion of intact and prosthetic limbs were compared to control values.
Results |
Joint kinematics of unilateral trans-tibial amputees was similar to that of controls. Individuals with a trans-femoral amputation walked with a more anterior tilted pelvis (P=0.006), with reduced range of pelvic obliquity (P=0.0023) and ankle plantarflexion (P<0.001) than controls. Across all amputee groups, hip joint moments and power were greater and knee and ankle joint moments were less than for controls.
Conclusions |
This is the first study to provide a comprehensive description of gait patterns of unilateral trans-tibial, trans-femoral and bilateral trans-femoral amputees as compared with healthy able-bodied individuals. The groups differed in joint kinematics and kinetics, but these can be expected in part because of limitations in prosthesis and socket designs. The results from this study could be considered benchmark data for healthcare professionals to compare gait patterns of other individuals with amputation who experienced similar injuries and rehabilitation services.
Le texte complet de cet article est disponible en PDF.Keywords : Amputation, Trans-tibial, trans-femoral, Kinematics, Kinetics, Gait, Biomechanics
Plan
Vol 64 - N° 1
Article 101395- janvier 2021 Retour au numéro
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