Pelvic motion in trans-femoral amputees in the frontal and transverse plane before and after special gait re-education

Using a special gait re-education programme, combining methods in physiotherapy with a psychological therapeutic approach to integrate the prosthesis with normal movements and to increase body awareness, the authors studied unilateral trans-femoral amputees aged 16-60 years with trauma or tumour as causes. In their service area they found 16 such current prosthetic users with at least 2 years of prosthetic experience and 9 who could complete the programme. Gait was measured before and after treatment and at 6 months follow-up with a three-dimensional motion analysis system and was compared to a reference group of 19 healthy volunteers of similar age. Results showed normalised gait speed and increased symmetry in step length after treatment, but reduced symmetry in pelvic motion. The reference group had a pelvic rotation of +/- 4 degrees both in the frontal and transverse planes. In the frontal plane, pelvic obliquity increased after treatment to a similar amplitude to the reference group, but with a different timing. Pelvic internal rotation on the amputated side increased to about 8 degrees in the beginning of stance. The amputated and the intact side before treatment were more symmetrical than afterwards and also when compared with the reference group. In spite of this; gait appeared to be more symmetrical, probably due to more efficient pelvic motion and more symmetrical upper-body movements. This was probably an effect of increased work with the intact side to compensate for the lack of power on the amputated side. These results remained at follow-up.