Article

Low back pain (LBP) is common in individuals with transfemoral amputation and may
result from altered gait mechanics associated with prosthetic use.
Inter-segmental coordination, assessed through continuous relative phase (CRP),
has been used to identify specific patterns as risk factors.
The purpose of this
study was to explore pelvis and trunk inter-segmental coordination across three
walking speeds in individuals with transfemoral amputations with and without LBP.
Nine individuals with transfemoral amputations with LBP and seven without pain
were compared to twelve able-bodied subjects. Subjects underwent a gait analysis
while walking at slow, moderate, and fast speeds.
CRP and CRP variability were
calculated from three-dimensional pelvis and trunk segment angles.
A two-way
ANOVA and post hoc tests assessed statistical significance. Individuals with
transfemoral amputation demonstrated some coordination patterns that were
different from able-bodied individuals, but consistent with previous reports on
persons with LBP. The patient groups maintained transverse plane CRP consistent
with able-bodied participants (p = 0.966), but not sagittal (p < 0.001) and
frontal plane CRP (p = 0.001). Sagittal and frontal CRP may have been
re-optimized based on new sets of constraints, such as protective rigidity of the
segments, muscular strength limitations, or prosthesis limitations. Patients with
amputations and without LBP exhibited few differences.
Only frontal and
transverse CRP shifted toward out-of-phase as speed increased in the patient
group with LBP. Although a cause and effect relationship between CRP and future
development of back pain has yet to be determined, these results add to the literature characterizing biomechanical parameters of back pain in high-risk populations.
CI - Published by Elsevier B.V.

Langue : ANGLAIS