Article

Prosthetic alignment is usually unchanged once optimized. However, a
previous study indicated that long-distance walking significantly altered gait
patterns, suggesting some alignment adjustments after walking are required. This
study investigated the effects of alignment changes (by inserting a heel lift) on
gait of a transtibial amputee before and after treadmill walking. METHODS: The subject walked, without heel lifts, on a treadmill
until perception of fatigue. Gait changes upon heel lifting at the prosthetic
side were studied before and after the treadmill walking FINDINGS AND OUTCOMES:
For this subject before the treadmill walking, heel lifting induced drop-off with
increased prosthetic-side knee flexion at mid-stance and pre-swing. The sound
limb outreached to stabilize the gait. After the treadmill walking, the same heel
lift did not induce drop-off. It reduced the plantar flexor power generation,
potentially delaying its fatigue. Conclusion: After walking prosthetic-side heel
lifting could be beneficial. CLINICAL RELEVANCE:
Many lower-limb amputees have
difficulties in long-distance walking due to muscle fatigue. This case study
proposes that appropriate alignment changes after some walking potentially
relieve fatigue and encourage them to walk longer distances.

Langue : ANGLAIS