title: Gait initiation in lower limb amputees.
abstract: OBJECTIVE
  To study limitations in function and adjustment strategies in lower limb amputees during gait initiation.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  University Medical Center.
  
  
  METHODS
  Amputees with a unilateral transfemoral or transtibial amputation, and able-bodied subjects.
  
  
  METHODS
  Leading limb preference, temporal variables, ground reaction forces, and centre of pressure shift.
  
  
  RESULTS
  Amputees demonstrated a decrease in peak anterior ground reaction force, a smaller or absent posterior centre of pressure shift, and a lower gait initiation velocity. The main adjustments strategies in amputees were more limb-loading on the non-affected limb, prolonging the period of propulsive force production in the non-affected limb and initiating gait preferably with the prosthetic limb.
  
  
  CONCLUSIONS
  Since an intact ankle joint and musculature is of major importance in gait initiation, functional limitations and adjustment strategies in transfemoral and transtibial amputees were similar. Improving prosthetic ankle properties and initiating gait with the prosthetic limb may facilitate the gait initiation process in amputees.
authors.affiliation: Center for Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands. a.h.vrieling@rev.umcg.nl
authors.forename: A H
authors.initials: AH
authors.lastname: Vrieling
authors.forename: H G
authors.initials: HG
authors.lastname: van Keeken
authors.forename: T
authors.initials: T
authors.lastname: Schoppen
authors.forename: E
authors.initials: E
authors.lastname: Otten
authors.forename: J P K
authors.initials: JP
authors.lastname: Halbertsma
authors.forename: A L
authors.initials: AL
authors.lastname: Hof
authors.forename: K
authors.initials: K
authors.lastname: Postema
mesh_terms: D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D000704:Analysis of Variance; D001186:Artificial Limbs; D015331:Cohort Studies; D005260:Female; D007839:Functional Laterality; D005684:Gait / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D012815:Signal Processing, Computer-Assisted