Differences in gait characteristics between persons with bilateral transtibial amputations, due to peripheral vascular disease and trauma, and able-bodied ambulators.
OBJECTIVE
To examine differences in gait characteristics between persons with bilateral transtibial amputations because of trauma and peripheral vascular disease (PVD); and to compare that with data from able-bodied controls that were previously collected and maintained in a laboratory database.


METHODS
Observational study of persons with bilateral transtibial amputations.


METHODS
A motion analysis laboratory.


METHODS
Nineteen bilateral transtibial amputees.


METHODS
No experimental intervention was performed. To standardize the effect of prosthetic foot type, subjects were fitted with Seattle Lightfoot II feet 2 weeks before quantitative gait analyses.


METHODS
Temporospatial, kinematic, and kinetic gait data were recorded and analyzed.


RESULTS
Results showed that the freely selected walking speeds of subjects with PVD and trauma were 0.69 m/s and 1.11 m/s, respectively, while that of able-bodied control subjects was 1.20 m/s. When data were compared on the basis of freely selected walking speed, numerous differences were found in temporospatial, kinematic, and kinetic parameters between the PVD and trauma groups. However, when data from similar speeds were compared, the temporospatial, kinematic, and kinetic gait data demonstrated no statistically significant differences between the 2 amputee groups. Although not statistically significant, the PVD group displayed increased knee (P=.09) and hip (P=.06) flexion during the swing phase, whereas the trauma group displayed increased pelvic obliquity (P=.06). These actions were believed to represent different strategies to increase swing phase foot clearance. Also, the PVD group exhibited slightly greater hip power (P=.05) before toe-off.


CONCLUSIONS
Many of the differences observed in the quantitative gait data between the trauma and PVD groups appeared to be directly associated with their freely selected walking speed; the trauma group walked at significantly faster freely selected speeds than the PVD group. When their walking speeds were matched, both amputee groups displayed similar gait characteristics, with the exception that they might use slightly different strategies to increase foot clearance.
Su
Po-Fu
PF
Department of Biomedical Engineering, McCormick School of Engineering and Applied Science, Northwestern University, Evanston, IL, USA. p-su@northwestern.edu
Gard
Steven A
SA
Lipschutz
Robert D
RD
Kuiken
Todd A
TA
D000328:Adult; D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007869:Leg Injuries / Q000150:complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications; D013977:Tibia / Q000601:surgery; D016138:Walking / Q000502:physiology