C T Barnett1, R C J Polman2, N Vanicek3. 1. SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom. Electronic address: cleveland.barnett@ntu.ac.uk. 2. Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia; School of Public Health, Tropical Medicine and Rehabilitation Science, James Cook University, Cairns, Australia. 3. Department of Sport, Health and Exercise Science, University of Hull, United Kingdom; Discipline of Exercise and Sport Science, Faculty of Health Sciences, University of Sydney, Australia.
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.
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.
Authors: Brecca M M Gaffney; Cory L Christiansen; Amanda M Murray; Bradley S Davidson Journal: Clin Biomech (Bristol, Avon) Date: 2017-07-29 Impact factor: 2.063
Authors: Brecca M M Gaffney; Cory L Christiansen; Amanda M Murray; Bradley S Davidson Journal: J Electromyogr Kinesiol Date: 2018-02-03 Impact factor: 2.368