Gait characteristics of individuals with transtibial amputations walking on a destabilizing rock surface

Deanna H Gates; Jonathan B Dingwell; Shawn J Scott; Emily H Sinitski; Jason M Wilken

doi:10.1016/j.gaitpost.2011.12.019

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Gait characteristics of individuals with transtibial amputations walking on a destabilizing rock surface

Journal article

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Gait characteristics of individuals with transtibial amputations walking on a destabilizing rock surface

Deanna H Gates, Jonathan B Dingwell, Shawn J Scott, Emily H Sinitski and Jason M Wilken

Gait & posture, Vol.36(1), pp.33-39

05/2012

DOI: 10.1016/j.gaitpost.2011.12.019

PMCID: PMC3372780

PMID: 22469772

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https://www.ncbi.nlm.nih.gov/pmc/articles/3372780View

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Abstract

► 13 Patients with transtibial amputations walked on level ground and a loose rock surface. ► Patients took shorter, wider steps on the rock surface. ► Patients increased hip and knee flexion, to increase toe clearance when walking on the rocks. ► Patients made adaptations on the rocks that were asymmetric, and initiated proximally. Individuals with transtibial amputation (TTA) have a high incidence of falls during walking. Environmental factors, such as uneven ground, often play a contributing role in these falls. The purpose of this study was to quantify the adaptations TTA made when walking on a destabilizing loose rock surface. In this study, 13 young TTA walked over a rock surface and level ground at four controlled speeds. Subjects successfully traversed the rock surface by adopting a conservative gait characterized by shorter and wider steps. They also took shorter steps with their prosthetic limbs and exhibited greater variability in foot placement when stepping onto their intact limb. Between-limb differences in step length and width variability increased at faster walking speeds. TTA increased hip and knee flexion during initial stance, which contributed lowering the whole-body center of mass. TTA also increased hip and knee flexion during swing, enabling them to significantly increase their toe clearance on the rock surface compared to level ground. Toe clearance on the prosthetic side was aided by increased ipsilateral hip flexion. The results suggest that TTA were able to adapt their gait to overcome the challenge imposed by the rock surface. These adaptations were asymmetric and initiated proximally.

Transtibial amputation

Falls

Walking

Uneven or irregular terrain

Kinematics

Details

Title: Subtitle: Gait characteristics of individuals with transtibial amputations walking on a destabilizing rock surface
Creators: Deanna H Gates - Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
Jonathan B Dingwell - Department of Kinesiology & Health Education, University of Texas, Austin, TX 78712, USA
Shawn J Scott - Moncrief Army Community Hospital, Fort Jackson, SC 29207, USA
Emily H Sinitski - Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
Jason M Wilken - Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
Resource Type: Journal article
Publication Details: Gait & posture, Vol.36(1), pp.33-39
DOI: 10.1016/j.gaitpost.2011.12.019
PMID: 22469772
PMCID: PMC3372780
NLM abbreviation: Gait Posture
ISSN: 0966-6362
eISSN: 1879-2219
Publisher: Elsevier B.V
Grant note: name: Military Amputee Research Program; name: NIH grant 1-R01-HD059844-01A1
Language: English
Date published: 05/2012
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984047775802771

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