Article

OBJECTIVE: To quantitatively analyze prosthetic limb swing phase gait strategies
used to adapt to cross slopes compared with flat surfaces. DESIGN:
Cross-sectional study. SETTING: Gait laboratory. PARTICIPANTS: A volunteer sample
(N=49) of individuals with transfemoral amputation (n=17), individuals with
transtibial amputation (n=15), and able-bodied individuals (n=17). INTERVENTIONS:
Participants walked on flat and 6 degrees (10%) inclined cross-slope surfaces at
a self-selected walking speed. MAIN OUTCOME MEASURES: Gait speed, step width,
sagittal plane kinematics (ankle, knee, hip) on the prosthetic side during swing
(uphill limb) and on the contralateral side during stance (downhill limb),
frontal plane pelvic kinematics on the prosthetic side during swing,
contralateral side ankle power during stance, and timing of gait events. RESULTS:
All groups reduced gait speed and downhill limb knee flexion during the stance
phase. Able-bodied participants adjusted their uphill limb ankle flexion during
the swing phase. Participants with lower limb amputation used additional
adjustments during the swing phase of the prosthetic limb when positioned uphill
on cross slopes. Transtibial amputee participants mainly adapted with increased
flexion of the residual hip and knee joints. Transfemoral amputee participants
primarily compensated using increased pelvic hiking and vaulting gait strategies.
CONCLUSIONS: The swing phase of the uphill limb during cross-slope walking
results in compensatory mechanisms that should be addressed during rehabilitation
to gain confidence and reduce avoidance when encountering cross slopes in daily
life.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS