Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning

Vanicek, Natalie, Strike, Siobhán C., and Polman, Remco (2015) Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning. Prosthetics and Orthotics International, 39 (4). pp. 322-332.

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Background: Stair negotiation is biomechanically more challenging than level gait. There are few biomechanical assessments of transtibial amputees descending stairs and none specifically related to falls. Stair descent may elicit more differences than level gait in amputees with and without a previous falls history.

Objectives: The aim of this study was to compare the gait kinematics of fallers and non-fallers during downwards step transitioning in transtibial amputees.

Study design: Cross-sectional study.

Methods: Six fallers and five non-fallers completed step transition trials on a three-step staircase at their self-selected pace.

Results: Nine participants exhibited a clear preference to lead with the affected limb, while two had no preference. Four participants self-selected a step-to rather than a reciprocal stair descent strategy. The fallers who used a reciprocal strategy walked 44% more quickly than the non-fallers. To compensate for the lack of active plantar flexion of the prosthetic foot, exaggerated range of motion occurred proximally at the pelvis during swing. The step-to group was more reliant on the handrails than the reciprocal group and walked more slowly.

Conclusion: As anticipated, the fallers walked faster than the non-fallers despite employing the more difficult 'roll-over' technique. Handrail use could help to improve dynamic control during downwards step transitions.

Item ID: 42064
Item Type: Article (Research - C1)
ISSN: 1746-1553
Keywords: biomechanics, gait analysis, gait, rehabilitation of amputees, rehabilitation
Date Deposited: 08 Dec 2015 14:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1106 Human Movement and Sports Science > 110601 Biomechanics @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920116 Skeletal System and Disorders (incl. Arthritis) @ 80%
92 HEALTH > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services) @ 20%
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