title: Longitudinal changes in transtibial amputee gait characteristics when negotiating a change in surface height during continuous gait.
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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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: SHAPE Research Group, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom. Electronic address: cleveland.barnett@ntu.ac.uk.
authors: C T
authors: CT
authors: Barnett
authors: 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.
authors: R C J
authors: RC
authors: Polman
authors: 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.
authors: N
authors: N
authors: Vanicek
mesh_terms: D000328:Adult; D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012046:Rehabilitation / Q000379:methods; D013647:Task Performance and Analysis; D013977:Tibia / Q000473:pathology*; D016138:Walking / Q000502:physiology*
keywords: Activity of daily living; Amputee; Gait; Kerb; Longitudinal; Raised surface; Stepping