Cross slope gait biomechanics for individuals with and without a unilateral transtibial amputation.

Clin Biomech (Bristol)

Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada; Department of Medicine (Division of Physical Medicine & Rehabilitation) and The Ottawa Hospital, University of Ottawa, Canada.

Published: August 2022


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Article Abstract

Background: This research was conducted to better understand compensatory strategies during cross-slope walking for adults with and without a unilateral transtibial amputation.

Methods: Fourteen individuals with unilateral transtibial amputation and 14 individuals with no lower limb amputation participated in this study. Motion and force data were captured while participants walked on a treadmill in a virtual reality environment for level and ± 5° cross slopes. Temporal-spatial parameters, kinematics (ankle, knee, hip, pelvis, trunk), and ground reaction forces were examined.

Findings: Compared to level, participants had similar step width but slightly longer steps for top-cross-slope and slightly shorter steps for bottom-cross-slope. Top-cross-slope required a more flexed limb with ankle eversion, and bottom-cross-slope required a more extended limb with ankle inversion. Participants had similar lateral pelvis and trunk motion for all walking conditions, but slightly more anterior trunk lean for top cross-slope with more anterior trunk lean observed for individuals with a lower limb amputation than without lower limb amputation. Participants with a lower limb amputation compensated for limited prosthetic ankle-foot dorsiflexion on the top-cross-slope by increasing prosthetic side hip flexion, reducing intact ankle/knee flexion, and increasing intact push-off force.

Interpretation: Gait adaptations during cross-slope walking were primarily in the lower extremities and were largely similar for those with and without a transtibial amputation. The information presented in this paper provides a better understanding of gait strategies adopted during cross-slope walking and can guide researchers and industry in prosthetic development.

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http://dx.doi.org/10.1016/j.clinbiomech.2022.105734DOI Listing

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