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Longitudinal changes in transtibial amputee gait characteristics when negotiating a change in surface height during continuous gait

Vanicek, N.; Barnett, C. T.; Polman, R. C.J.

Authors

C. T. Barnett

R. C. J. Polman

Abstract

Background Negotiating a raised surface during continuous gait is an important activity of daily living and is a potentially hazardous task with regards to trips, falls and fall-related injury. However, it is not known how recent transtibial amputees adapt to performing stepping gait tasks in the 6-month period following discharge from rehabilitation. Methods Recent transtibial amputees performed continuous gait trials, stepping onto and from a raised surface walkway representing the height of a street kerb, whilst kinematic and kinetic data were recorded at one, three and six months post-discharge from rehabilitation. Findings Walking speed increased when stepping down (p = 0.04) and was invariant across the study period when stepping up. At one month post-discharge, participants displayed an affected lead limb preference (90.8%) when stepping down and an intact lead limb preference (70.0%) when stepping up, although these lead limb preferences diminished over time. Participants spent more time in stance on the intact limb compared to the affected limb in both stepping down (trail limb) (p = 0.01) and stepping up (lead and trail limbs) (p = 0.05). Participants displayed significantly greater joint mobility and power bursts in the intact trail limb when stepping down and in the intact lead limb when stepping up. Interpretation Transtibial amputees prefer to exploit intact limb function to a greater extent, although over time, the means by which this occurs changes which affects the initial lead limb preferences. The results from the current study enable future evidence-based therapeutic and prosthetic interventions to be designed that improve transtibial amputee stepping gait.

Journal Article Type Article
Publication Date 2014-08
Journal Clinical biomechanics
Print ISSN 0268-0033
Electronic ISSN 1879-1271
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 29
Issue 7
Pages 787-793
DOI https://doi.org/10.1016/j.clinbiomech.2014.05.012
Keywords Gait; Longitudinal; Amputee; Activity of daily living; Stepping; Raised surface; Kerb
Publisher URL http://www.sciencedirect.com/science/article/pii/S0268003314001314
Copyright Statement © 2014, Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Additional Information Authors' accepted manuscript of article published in: Clinical biomechanics, v.29, issue 7

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