Article

Obstacle crossing is an important activity of daily living, necessary
to avoid tripping or falling, although it is not fully understood how transtibial
amputees adapt to performing this activity of daily living following discharge
from rehabilitation. The objective of this study was to investigate
the longitudinal adaptations in obstacle crossing in transtibial amputees
post-discharge from rehabilitation. STUDY DESIGN: Longitudinal repeated measures.
METHODS: Seven unilateral transtibial amputees crossed an obstacle 0.1m high
positioned along a walkway while kinematic and kinetic data were recorded at 1, 3
and 6 months post-discharge. RESULTS: At 6 months post-discharge, walking
velocity had increased (0.17 m.s(-1)) with most participants self-selecting an
intact lead limb preference. During swing phase, peak knee flexion (p = 0.03) and
peak knee power absorption (K4; p = 0.01) were greater with an intact versus
affected lead limb preference. Having crossed the obstacle, intact limb peak
ankle power generation in pre-swing (A2; p = 0.01) and knee power absorption (K3;
p = 0.05) during stance phase were greater when compared to the affected limb.
CONCLUSIONS: Obstacle crossing improved, although a greater reliance on intact
limb function was highlighted. Results suggested that further improvements to
locomotor performance may be obtained by increasing affected limb knee range of
motion and concentric and eccentric strength of the knee extensors and flexors.
CLINICAL RELEVANCE: The novel objective data from this study establish an
understanding of how recent transtibial amputees adapt to performing obstacle
crossing following discharge from rehabilitation. This allows for evidence-based
clinical interventions to be developed, aimed at optimising biomechanical
function, thus improving overall locomotor performance and perhaps subsequent
quality of life.
CI - (c) The International Society for Prosthetics and Orthotics 2013.

Langue : ANGLAIS