Article

Prosthetic gait is often asymmetric in step length, but the direction of this
asymmetry varies inconsistently across amputees. This situation is akin to that
seen in stroke patients, where step-length asymmetry has been shown to be the
additive result of asymmetries in trunk progression and asymmetries in forward
foot placement relative to the trunk. The present study examined the validity of
this notion in three trans-tibial and seven trans-femoral amputees wearing a
unilateral prosthesis while walking over a walkway at a comfortable and
slower-than-comfortable speed. The latter manipulation was added to examine the
expectation that the magnitude of the trunk-progression asymmetry - attributable
to a weaker propulsion generating capacity on the prosthetic side - would be
smaller when walking slower because of the diminished propulsion demands. Step
length, forward foot placement relative to the trunk, and trunk progression of
prosthetic and non-prosthetic steps, as well as asymmetries therein, were
quantified. The direction of step-length and forward foot placement asymmetries
varied inconsistently across (but consistently within) participants. As expected,
step-length asymmetry depended on the combination of asymmetries in forward foot
placement and trunk progression, with a smaller contribution of trunk-progression
asymmetry at slow speed. These results extend our previous finding for hemiplegic
patients that an analysis of gait asymmetry in terms of step length alone is
flawed to prosthetic gait, implying that knowledge of asymmetries in trunk
progression and forward foot placement relative to the trunk is required to help
elucidate the contribution of underlying impairments (viz. propulsion generating
capacity) and adopted compensations on prosthetic gait asymmetry.
CI - Copyright A(c) 2011 Elsevier B.V. All rights reserved.

Langue : ANGLAIS