Article

For people with lower extremity amputations, the decreased confidence
and suboptimal gait associated with dynamic instability can negatively affect
mobility and quality of life. Quantifying dynamic instability could enhance
clinical decision making related to lower extremity prosthetics and inform future
prosthetic research. OBJECTIVE: To quantitatively examine gait adaptations in
transfemoral amputees across various walking conditions. STUDY DESIGN:
Cross-sectional study. METHODS: Plantar-pressure data were collected from 11
individuals with unilateral transfemoral amputations using an in-shoe
plantar-pressure measurement system while navigating rigid and soft ground, ramp,
and stair conditions. Six parameters were examined: anterior-posterior and
medial-lateral center-of-pressure direction changes, sensor cell loading
frequency (cell triggering), maximum lateral force position, double support time,
and stride time. Paired t-tests and analyses of variance were used to examine
differences between limbs and walking conditions, respectively. RESULTS: Values
for medial-lateral center-of-pressure direction change, sensor cell loading
frequency, and double support time were significantly greater on the intact limb
than the prosthetic limb. Significant differences between conditions occurred
only for anterior-posterior center-of-pressure direction change and double
support time on the prosthetic limb. CONCLUSION: Higher values on the intact limb
suggest that it plays a key role in maintaining stability and optimizing body
progression during different tasks. Differences between participants, limbs, and
walking condition indicate parameter sensitivity to adaptive gait strategies.
CLINICAL RELEVANCE: This plantar-pressure-based approach is a viable option for
point-of-care evaluation of locomotor performance, across common various mobility
tasks and activities of daily living. The information obtained could be valuable
for prosthetic prescription and optimization of prosthetic fit and alignment,
potentially improving mobility for prosthetic users with dynamic stability
deficits.
CI - (c) The International Society for Prosthetics and Orthotics 2015.

Langue : ANGLAIS