Can high-functioning amputees with state-of-the-art prosthetics walk normally? A kinematic and dynamic study of 40 individuals

Jarvis, HL; Reeves, ND; Twiste, M; Phillip, RD; Etherington, J; Bennett, AN

Abstract

Background
Previous work has highlighted the highly functional post-rehabilitation level of military individuals who sustained traumatic amputation. Understanding how these individuals walk with their prosthesis could be key to
setting a precedent for what is realistically possible in the rehabilitation of individuals with amputations.
Objective
The aim of this paper is to answer how “normal” should the gait of an individual with an amputation(s) be and can we aspire to mimic able-bodied gait with the most advanced prosthetics in highly functioning
individuals?
Methods
This was a cross-sectional study comparing the gait of severely injured and highly functional UK trans-tibial (n = 10), trans-femoral (n = 10) and bilateral trans-femoral (n = 10) military amputees after completion of their
rehabilitation programme to that of able-bodied controls (n = 10). Joint kinematics and kinetics of the pelvis, hip, knee and ankle were measured with 3-D gait analysis during 5 min of walking on level ground at a self-selected
speed. Peak angle, moment or range of motion of intact and prosthetic limbs were compared to control values.
Results
Joint kinematics of unilateral trans-tibial amputees was similar to that of controls. Individuals with a trans-femoral amputation walked with a more anterior tilted pelvis (P = 0.006), with reduced range of pelvic obliquity
(P = 0.0023) and ankle plantarflexion (P < 0.001) than controls. Across all amputee groups, hip joint moments and power were greater and knee and ankle joint moments were less than for controls.
Conclusions
This is the first study to provide a comprehensive description of gait patterns of unilateral trans-tibial, trans-femoral and bilateral trans-femoral amputees as compared with healthy able-bodied individuals. The groups
differed in joint kinematics and kinetics, but these can be expected in part because of limitations in prosthesis and socket designs. The results from this study could be considered benchmark data for healthcare professionals
to compare gait patterns of other individuals with amputation who experienced similar injuries and rehabilitation services.

Citation

Jarvis, H., Reeves, N., Twiste, M., Phillip, R., Etherington, J., & Bennett, A. (2021). Can high-functioning amputees with state-of-the-art prosthetics walk normally? A kinematic and dynamic study of 40 individuals. Annals of Physical and Rehabilitation Medicine, 64(1), 101395. https://doi.org/10.1016/j.rehab.2020.04.007

• Journal Article Type: Article
• Acceptance Date: Apr 23, 2020
• Online Publication Date: Aug 26, 2020
• Publication Date: Jan 1, 2021
• Deposit Date: May 29, 2020
• Publicly Available Date: Aug 26, 2021
• Journal: Annals of Physical and Rehabilitation Medicine
• Print ISSN: 1877-0657
• Publisher: Elsevier
• Volume: 64
• Issue: 1
• Pages: 101395
• DOI: https://doi.org/10.1016/j.rehab.2020.04.007
• Publisher URL: https://doi.org/10.1016/j.rehab.2020.04.007
• Related Public URLs: http://www.elsevier.com/journals/annals-of-physical-and-rehabilitation-medicine/1877-0657/