期刊
CLINICAL BIOMECHANICS
卷 80, 期 -, 页码 -出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.clinbiomech.2020.105102
关键词
Dysvascular transtibial amputation; Inter-limb asymmetry; Joint mechanics; Gait; Step ascent
资金
- Eunice Kennedy Shriver National Institute of Child Health and Human Development [K12 HD055931]
- National Center for Advancing Translational SciencesColorado Clinical & Translational Sciences Institute [UL1 TR002535, TL1 TR002533]
- Eastern Colorado Veterans Affairs Geriatrics Research, Education, and Clinical Center
Background: Movement asymmetries between lower limbs are commonly exhibited by adults after transtibial amputation. However, the degree of movement asymmetry between low- and high-demand functional tasks remains unknown. Methods: Kinematic and kinetic data were collected during overground walking (low-demand) and step ascent (high-demand) tasks for two groups: 1) persons with transtibial amputation and 2) healthy matched peers. Analysis of covariance was used to compare sagittal-plane peak knee moment and joint angle (primary) and hip and ankle moments and joint angles, vertical ground reaction force and impulse (secondary). Findings: Within transtibial amputation group comparisons showed significantly greater between-limb asymmetry in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .05), peak ankle angle (p < .01) and peak ankle moment (p < .01) with the step ascent task compared to overground walking. The transtibial amputation group had greater between-limb asymmetry during step ascent in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .04) and peak ankle angle (p < .01) than healthy matched peers. During overground walking, the transtibial amputation group had greater between-limb asymmetry in peak vertical impulse (p = .05) and peak ankle moment (p < .01) than healthy matched peers. Interpretation: Movement asymmetry is increased during step ascent compared to overground walking for adults with transtibial amputation. While the restoration of overground walking is the focus of post-amputation rehabilitation and prosthetic design, higher demand tasks should also be considered to maximize mobility for adults with transtibial amputation.
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