Article

OBJECTIVE: To describe and compare the plantar pressures, temporal foot
roll-over, and ground reaction forces (GRFs) between both limbs of subjects with
unilateral transfemoral amputation and with those of able-bodied participants
during walking. We also verify the relevance of a force plate and a pressure
plate to discriminate changes in gait parameters of subjects with limb loss.
DESIGN: Cross-sectional study. SETTING: Biomechanics laboratory. SUBJECTS: A
total of 14 subjects with unilateral transfemoral amputation and 21 able-bodied
participants. METHODS: We used a force plate and a pressure plate to assess
biomechanical gait parameters while the participants were walking at their
self-selected gait speed. MAIN OUTCOME MEASUREMENTS: We measured plantar pressure
peaks in 6 foot regions and the instant of their occurrence (temporal foot
roll-over); and GRF peaks and impulses of anterior-posterior (braking and
propulsive phases), medial-lateral, and vertical (load acceptance and thrust
phases) components. RESULTS: The thrust, braking, and propulsive peaks, and the
braking and propulsive impulses, were statistically significantly lower in the
amputated limb than in the sound limb (P < .05) and in able-bodied participants
(P < .05). In the amputated limb, we observed higher pressure peaks in the
lateral rearfoot and medial and lateral midfoot, and lower values in the forefoot
regions compared to those in the other groups (P < .05). The temporal foot
roll-over showed statistically significant differences among the groups (P <
.05). CONCLUSIONS: The plantar pressures, temporal foot roll-over, and GRFs in
subjects with unilateral transfemoral amputation showed an asymmetric gait
pattern, and different values were observed in both of their lower limbs as
compared with those of able-bodied subjects during walking. The force plate and
pressure plate were able to determine differences between participants in gait
pattern, suggesting that both plantar pressure and GRF analyses are useful tools
for gait assessment in individuals with unilateral transfemoral amputation.
Because of the convenience of pressure plates, their use in the clinical context
for prosthetic management appears relevant to guide the rehabilitation of
subjects with lower limb amputation.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS