title: Lower limb kinematic and kinetic differences between transtibial amputee fallers and non-fallers.
abstract: Stair walking relies on concentric contraction of the ankle plantarflexor and knee extensor muscles, which are either absent or weakened in transtibial amputees. As a result the risk of falling is increased in this population. The aim of this study was to compare the gait patterns of transtibial amputee fallers and non-fallers during stair ascent. Eleven participants (fallers = 6; non-fallers = 5) walked along a 3-m walkway and ascended a three-step staircase with handrails, at their self-selected pace, while three-dimensional kinematic data were collected from the lower limbs. A force plate was embedded into the first step and kinetic data were measured for the intact lead limb only. The fallers walked significantly faster (p = 0.00) and exhibited less hip flexion (p = 0.05) and less anterior pelvic tilt (p = 0.04) compared to the non-fallers. The fallers had significantly greater first and second peak vertical ground reaction force (GRF) on the intact limb than the non-fallers (p = 0.05 and p = 0.01, respectively) contributing to the significantly larger ankle (p = 0.02) and hip moments (p = 0.04). These findings suggested the amputee non-fallers performed mechanically demanding tasks more cautiously. Two of the participants self-selected a 'step to' gait pattern, ascending one step at a time. This may be considered a compensatory mechanism for the lack of ankle mobility and functional muscle performance in these two transtibial amputees.
authors.affiliation: Department of Sport, Health & Exercise Science, University of Hull, Hull, UK. N.Vanicek@hull.ac.uk
authors.forename: Natalie
authors.initials: N
authors.lastname: Vanicek
authors.forename: Siobhan Catherine
authors.initials: SC
authors.lastname: Strike
authors.forename: Lars
authors.initials: L
authors.lastname: McNaughton
authors.forename: Remco
authors.initials: R
authors.lastname: Polman
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation / Q000706:statistics & numerical data; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena; D005684:Gait / Q000502:physiology*; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007596:Joints / Q000502:physiology*; D007700:Kinetics; D007719:Knee Joint / Q000502:physiology; D008875:Middle Aged; D012307:Risk Factors; D013977:Tibia / Q000601:surgery*; D016138:Walking / Q000502:physiology