Article

OBJECTIVE: To describe the adjustments in gait characteristics of obstacle
crossing, gait initiation and gait termination that occur in subjects with a
recent lower limb amputation during the rehabilitation process. SUBJECTS: Fourteen subjects with a recent
transfemoral, knee disarticulation or transtibial amputation. METHODS: Subjects
stepped over an obstacle and initiated and terminated gait at four different
times during the rehabilitation process. OUTCOME MEASURES: Success rate, gait
velocity and lower limb joint angles in obstacle crossing, centre of pressure
shift and peak anteroposterior ground reaction force in gait initiation and
termination. RESULTS: In obstacle crossing amputees increased success rate, gait
velocity and swing knee flexion of the prosthetic limb. Knee flexion in
transfemoral and knee disarticulation amputees was not sufficient for safe
obstacle crossing, which resulted in a circumduction strategy. In gait initiation
and termination amputees increased the anteroposterior ground reaction force and
the centre of pressure shift in the mediolateral direction in both tasks.
Throughout the rehabilitation process the centre of pressure was shifted
anteriorly before single-limb stance on the trailing prosthetic limb in gait
initiation, whereas in gait termination the centre of pressure in single-limb
stance remained posterior when leading with the prosthetic limb. CONCLUSION:
Subjects with a recent amputation develop adjustment strategies to improve
obstacle crossing, gait initiation and gait termination. Innovations in
prosthetic design or training methods may ease the learning process of these
tasks.

Langue : ANGLAIS