title: Persons with unilateral transfemoral amputation have altered lumbosacral kinetics during sitting and standing movements.
abstract: Increases in spinal loading have been related to altered movements of the lower back during gait among persons with lower limb amputation, movements which are self-perceived by these individuals as contributing factors in the development of low back pain. However, the relationships between altered trunk kinematics and associated changes in lumbosacral kinetics during sit-to-stand and stand-to-sit movements in this population have not yet been assessed. Three-dimensional lumbosacral kinetics (joint moments and powers) were compared between 9 persons with unilateral transfemoral amputation (wearing both a powered and passive knee device), and 9 uninjured controls, performing five consecutive sit-to-stand and stand-to-sit movements. During sit-to-stand movements, lumbosacral joint moments and powers were significantly larger among persons with transfemoral amputation relative to uninjured controls. During stand-to-sit movements, lumbosacral joint moments and powers were also significantly larger among persons with transfemoral amputation relative to uninjured controls, with the exception of sagittal joint powers. Minimal differences in kinetic measures were noted between the powered and passive knee devices among persons with transfemoral amputation across all conditions. Altered lumbosacral kinetics during sitting and standing movements, important activities of daily living, may play a biomechanical role in the onset and/or recurrence of low back pain or injury among persons with lower-limb amputation.
authors.affiliation: Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; Department of Physical Medicine and Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA. Electronic address: bradford.hendershot@gmail.com.
authors.forename: Brad D
authors.initials: BD
authors.lastname: Hendershot
authors.affiliation: Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; Department of Physical Medicine and Rehabilitation, Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA; DOD/VA Extremity Trauma and Amputation Center of Excellence, JBSA-Fort Sam Houston, TX, USA.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation; D001696:Biomechanical Phenomena / Q000502:physiology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D012307:Risk Factors; D012447:Sacrum / Q000503:physiopathology*; D016474:Weight-Bearing / Q000502:physiology
keywords: Biomechanics; Low back; Moment; Power; Trunk