Article

The anatomical foot-ankle complex facilitates advancement of the
stance limb through foot rockers and late-stance power generation during walking,
but this mechanism is altered for persons with bilateral transtibial amputation
when using passive prostheses. OBJECTIVES: To study the effects of bilateral foot
and ankle immobilization on able-bodied gait to serve as a model for
understanding gait of persons with bilateral transtibial amputation and
associated compensatory mechanisms. STUDY DESIGN: Comparative analysis. METHODS:
Nine able-bodied persons walked at self-selected slow, normal, and fast speeds.
They performed trials unaltered and when fitted with bilateral foot and
ankle-immobilizing casts. Data from 10 individuals with bilateral transtibial
amputation walking at self-selected fast speeds were used for qualitative
comparison. RESULTS: The average speeds for the able-bodied fast speed cast and
normal speed no-cast trials were similar and were compared with bilateral
transtibial amputation data. The able-bodied cast condition data more closely
matched bilateral transtibial amputation data than the no-cast data. Ankle
range-of-motion and power generation at pre-swing in the cast condition were
markedly decreased, while trunk lateral flexion and transverse rotation
range-of-motion and peak hip power generation increased. CONCLUSION: Results
suggest that the absence of active ankle range-of-motion and power generation
contributes to the development of characteristic compensatory gait mechanisms
displayed by persons with bilateral transtibial amputation. Clinical relevance
This study helps to improve understanding of compensatory mechanisms resulting
from reduced foot and ankle joint motion to inform lower limb prosthesis design
and function for improving gait quality of individuals with bilateral transtibial
amputation.

Langue : ANGLAIS