Common and specific gait patterns in people with varying anatomical levels of lower limb amputation and different prosthetic components |
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| Institution: | 1. Department of Engineering, Roma TRE University, Via Vito Volterra 62, 00146 Rome, Italy;2. Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Via Faggiana 34, 40100 Latina, Italy;3. Rehabilitation Centre, Policlinico Italia, Rome, Italy;4. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy;5. Centro Protesi INAIL, Ospedale C.T.O. Andrea Alesini, Via San Nemesio, 21, 00145 Rome, Italy;6. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy;1. Department of Prosthetic and Orthotics, Research Institute, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa-Shi, Saitama 359-8555, Japan;2. Hospital, National Rehabilitation Center for Persons with Disabilities, 4-1 Namiki, Tokorozawa-Shi, Saitama 359-8555, Japan;1. Florida Gulf Coast University, 10501 FGCU Blvd. S., Fort Myers, FL 33965, USA;2. University of South Florida, 4202 E. Fowler Ave., Tampa, FL 33620, USA;3. OP Solutions, 12206 Bruce B Downs Blvd, Tampa, FL 33612, USA;5. Extremity Trauma & Amputation Center of Excellence, US Department of Veterans Affairs, Tampa, FL, USA;6. US Army Reserves, 319th Minimal Care Detachment, Pinellas Park, FL, USA;1. Faculty of medicine, Department of Kinesiology, Laval University, Quebec, Canada;2. Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, Canada |
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| Abstract: | The present study’s aim was to identify the kinematic and kinetic gait patterns and to measure the energy consumption in people with amputation according to both the anatomical level of amputation and the type of prosthetic components in comparison with a control group matched for the gait speed. Fifteen subjects with unilateral transtibial amputation (TTA), forty with unilateral transfemoral amputation (TFA) (9 with mechanical, 17 with CLeg and 14 with Genium prosthesis) and forty healthy subjects were recruited. We computed the time-distance gait parameters; the range of angular motion (RoM) at hip, knee and ankle joints, and at the trunk and pelvis; the values of the 2 peaks of vertical force curve; the full width at half maximum (FWHM) and center of activity (CoA) of vertical force; the mechanical behavior in terms of energy recovery (R-step) and energy consumption. The main results were: i) both TTA and TFA show a common gait pattern characterized by a symmetric increase of step length, step width, double support duration, pelvic obliquity, trunk lateral bending and trunk rotation RoMs compared to control groups. They show also an asymmetric increase of stance duration and of Peak1 in non-amputated side and a decrease of ankle RoM in amputated side; ii) only TFA show a specific gait pattern, depending on the level of amputation, characterized by a symmetric reduction of R-step and an asymmetric decrease of stance duration, CoA and FWHM and an increase of Peak1 in the amputated side and of hip and knee RoM, CoA and FWHM in the non-amputated side; iii) people with amputation with Genium prosthesis show a longer step length and increased hip and knee RoMs compared to people with amputation with mechanical prosthesis who conversely show an increased pelvic obliquity: these are specific gait patterns depending of the type of prosthesis. In conclusion, we identified both common and specific gait patterns in people with amputation, either regardless of, or according to their level of amputation and the type of prosthetic component. |
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| Keywords: | Lower limb amputation Prosthetic gait Kinematic Kinetic Energetic gait parameters |
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