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Lower limb kinematic and kinetic differences between transtibial amputee fallers and non-fallers

Vanicek, Natalie; Strike, Siobhan Catherine; McNaughton, Lars; Polman, Remco

Authors

Siobhan Catherine Strike

Lars McNaughton

Remco Polman



Abstract

Stair walking relies on concentric contraction of the ankle plantarflexor and knee extensor muscles, which are either absent or weakened in transtibial amputees. As a result the risk of falling is increased in this population. The aim of this study was to compare the gait patterns of transtibial amputee fallers and non-fallers during stair ascent. Eleven participants (fallers6; non-fallers5) walked along a 3-m walkway and ascended a three-step staircase with handrails, at their self-selected pace, while three-dimensional kinematic data were collected from the lower limbs. A force plate was embedded into the first step and kinetic data were measured for the intact lead limb only. The fallers walked significantly faster (p=0.00) and exhibited less hip flexion (p=0.05) and less anterior pelvic tilt (p=0.04) compared to the non-fallers. The fallers had significantly greater first and second peak vertical ground reaction force (GRF) on the intact limb than the non-fallers (p=0.05 and p=0.01, respectively) contributing to the significantly larger ankle (p=0.02) and hip moments (p=0.04). These findings suggested the amputee non-fallers performed mechanically demanding tasks more cautiously. Two of the participants self-selected a 'step to' gait pattern, ascending one step at a time. This may be considered a compensatory mechanism for the lack of ankle mobility and functional muscle performance in these two transtibial amputees. © 2010 ISPO.

Citation

Vanicek, N., Strike, S. C., McNaughton, L., & Polman, R. (2010). Lower limb kinematic and kinetic differences between transtibial amputee fallers and non-fallers. Prosthetics and orthotics international, 34(4), 399-410. https://doi.org/10.3109/03093646.2010.480964

Journal Article Type Article
Online Publication Date Dec 1, 2010
Publication Date Dec 1, 2010
Deposit Date Jan 21, 2021
Journal Prosthetics and Orthotics International
Print ISSN 0309-3646
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 34
Issue 4
Pages 399-410
DOI https://doi.org/10.3109/03093646.2010.480964
Keywords Gait; Stairs; Transtibial amputee; Falls; Biomechanics
Public URL https://hull-repository.worktribe.com/output/3635310
Publisher URL https://journals.sagepub.com/doi/10.3109/03093646.2010.480964