Influence of speed on gait parameters and on symmetry in transtibial amputees

Abstract

Normal gait is characterised by a high level of inter-leg symmetry of gait parameters. Therefore, efforts in rehabilitation of amputees are directed at the construction of a prosthesis which provides normal leg function and allows a more symmetrical gait. Analysis of the gait of trans-tibial amputees was performed when they were ambulating at their own freely selected speed and at a faster speed. The effect of speed on selected gait parameters in each leg was evaluated and the influence on symmetry established by comparing the inter-leg changes for each of the selected parameters. The faster gait trail affected significantly all temporal and distance parameters in both legs but not the level of symmetry between legs. At the faster speed, the hip angles at heel-strike and during swing and the knee angle during load response, in the normal leg, and the knee angle during swing in the amputated leg, all increased significantly. Speed of gait significantly affected symmetry between knee angles as reflected by the increased differences measured during load response (from 2.62 ±5.2 to 7.06 ±4.2 degrees) and during toe-off (from 1.80 ±7.4 to 9.50 ±9.1 degrees). Timing and sequence of selected gait events, as related to stride time, were not significantly affected by speed of gait. These results might contribute to a better understanding of gait characteristics in trans-tibial amputees and provide design guidance for prosthetic components.

Biomechanical parameters of gait among transtibial amputees: a review

“…Different results were found by Isakov et al 7 from analyzing the effect of speed on the symmetry between the limbs of fourteen amputees with SACH feet (nine with PTB sockets and five with a supracondylar tibial prosthesis) at a natural walking speed (0.9 m/s) and a fast speed (1.4 m/s). The stance duration, double-limb stance duration, step duration and step length were symmetrical at the two speeds and in the pairs of legs.…”

“…3,4 Kinematics can be defined as the field of movement description, irrespective of the force caused. With regard to such parameters, we found different combinations of results between PL and NAL, 3,[5][6][7] marked by individual characteristics and by the components of the prostheses used in different studies. Isakov et al 5 analyzed the natural speed of walking (1.25 m/s) among fourteen volunteers with prostheses composed of patellar tendon bearing (PTB) sockets and solid ankle cushion heel (SACH) feet.…”

“…Studies in the field of kinematics have mainly emphasized descriptions of space-time parameters in order to analyze the symmetry between limbs. [3][4][5][6][7] In addition, they offer the possibility of evaluating the success of the rehabilitation process. 8,9 Studies on kinetics seek to elucidate the mechanisms for control and management of movement, 2,10,11 and to provide ample knowledge of the behavior of the ground reaction force (GRF).…”

“…5,[12][13][14][15] Through electromyography, the main muscle strategies developed can be elucidated. 5,11,16,17 In all cases, the influence of prosthetic components such as feet, 10,15,[18][19][20][21] factors in experimental protocols such as speed 6,7,17,21 and characteristics of amputation 15 are noted in relation to movement.…”

Spatio Temporal Parameters and Symmetry Index in Transtibial Amputees Wearing Prosthetic Feet with and without Adaptive Ankles

“…The comparison of STP between the prosthetic and sound limb, measured by the symmetry index also provides useful information. For example, often the stance phase for the sound limb of lower limb amputees is slightly longer than on the prosthetic side, contributing to a more asymmetrical gait [22], [23]. This is partly caused by subjects relying more on their sound leg to compensate for some of the deficiencies associated with prostheses.…”