Article

BACKGROUND: It has long been reported that a range of prosthesis alignments is
acceptable in trans-tibial prosthetics. This range was shown to be smaller when
walking on uneven surfaces.
It has also been argued that findings on gait with
prostheses that were obtained under laboratory conditions are limited in their
applicability to real-life environments. OBJECTIVES:
This study investigated the
hypothesis that efforts to compensate for suboptimal alignments by active users
of trans-tibial prostheses become less effective when levels of physical exertion
increase. STUDY DESIGN: A 2 x 2 repeated-measures analysis of variance was
conducted to compare the effects of physical exertion and subtle alignment
perturbations on gait with trans-tibial prostheses. METHODS: The gait of eight
subjects with trans-tibial amputation was analyzed when walking with two
different prosthesis alignments and two different physical exertion levels. The
main and interaction effects were statistically evaluated. RESULTS: Bilateral
step length symmetry and measures of step variability within the same leg were
found to be affected by the intervention. There was no significant effect on
index variables that combined kinematic or kinetic measures. CONCLUSION: Findings
showed that persons with trans-tibial prostheses responded heterogeneously to the
interventions. For most variables, the research hypothesis could not be
confirmed. CLINICAL RELEVANCE: Findings support the practice of allotting several
sessions to the alignment of trans-tibial prostheses, as users' gait responds
differently to perturbations when external factors (e.g. exertion) change.
Furthermore, the found inhomogeneity in the population of persons with
trans-tibial amputation supports the use of technical gait assessment methods in
clinical practice.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS