Gait adjustments in obstacle crossing, gait initiation and gait termination after a recent lower limb amputation

Aline H. Vrieling*, Helco G. van Keeken, Tanneke Schoppen, At L. Hof, Bert Otten, Jan P. K. Halbertsma, Klaas Postema

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

22 Citations (Scopus)

Abstract

Objective: To describe the adjustments in gait characteristics of obstacle crossing, gait initiation and gait termination that occur in subjects with a recent lower limb amputation during the rehabilitation process.

Design: Prospective and descriptive study.

Subjects: Fourteen subjects with a recent transfemoral, knee disarticulation or transtibial amputation.

Methods: Subjects stepped over an obstacle and initiated and terminated gait at four different times during the rehabilitation process.

Outcome measures: Success rate, gait velocity and lower limb joint angles in obstacle crossing, centre of pressure shift and peak anteroposterior ground reaction force in gait initiation and termination.

Results: In obstacle crossing amputees increased success rate, gait velocity and swing knee flexion of the prosthetic limb. Knee flexion in transfemoral and knee disarticulation amputees was not sufficient for safe obstacle crossing, which resulted in a circumduction strategy. In gait initiation and termination amputees increased the anteroposterior ground reaction force and the centre of pressure shift in the mediolateral direction in both tasks. Throughout the rehabilitation process the centre of pressure was shifted anteriorly before single-limb stance on the trailing prosthetic limb in gait initiation, whereas in gait termination the centre of pressure in single-limb stance remained posterior when leading with the prosthetic limb.

Conclusion: Subjects with a recent amputation develop adjustment strategies to improve obstacle crossing, gait initiation and gait termination. Innovations in prosthetic design or training methods may ease the learning process of these tasks.

Original languageEnglish
Pages (from-to)659-671
Number of pages13
JournalClinical Rehabilitation
Volume23
Issue number7
DOIs
Publication statusPublished - Jul-2009

Keywords

  • BELOW-KNEE AMPUTATION
  • PROSTHETIC FEET
  • HUMAN WALKING
  • AMPUTEE GAIT
  • OLDER-ADULTS
  • SOUND LIMB
  • SACH FOOT
  • LOCOMOTION
  • ORGANIZATION
  • STRATEGIES

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