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

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

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
• Electronic ISSN: 1746-1553
• 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