Biomechanical Compensations of the Trunk and Lower Extremities during Stepping Tasks after Unilateral Transtibial Amputation

Publication Date

8-30-2017

Document Type

Article

Organizational Units

Daniel Felix Ritchie School of Engineering and Computer Science, Center for Orthopaedic Biomechanics, Mechanical and Materials Engineering

Keywords

Dysvascular amputation, Diabetes, Biomechanics, Stairs

Abstract

Background

Lower extremity movement compensations following transtibial amputation are well-documented and are likely influenced by trunk posture and movement. However, the biomechanical compensations of the trunk and lower extremities, especially during high-demand tasks such as step ascent and descent, remain unclear.

Methods

Kinematic and kinetic data were collected during step ascent and descent tasks for three groups of individuals: diabetic/transtibial amputation, diabetic, and healthy. An ANCOVA was used to compare peak trunk, hip and knee joint angles and moments in the sagittal and frontal planes between groups. Paired t-tests were used to compare peak joint angles and moments between amputated and intact limbs of the diabetic/transtibial amputation group.

Findings

During step ascent and descent, the transtibial amputation group exhibited greater trunk forward flexion and lateral flexion compared to the other two groups (P < 0.016), which resulted in greater low back moments and asymmetric loading patterns in the lower extremity joints. The diabetic group exhibited similar knee joint loading patterns compared to the amputation group (P < 0.016), during step descent.

Interpretation

This study highlights the biomechanical compensations of the trunk and lower extremities in individuals with dysvascular transtibial amputation, by identifying low back, hip, and knee joint moment patterns unique to transtibial amputation during stepping tasks. In addition, the results suggest that some movement compensations may be confounded by the presence of diabetes and precede limb amputation. The increased and asymmetrical loading patterns identified may predispose individuals with transtibial amputation to the development of secondary pain conditions, such as low back pain or osteoarthritis.

Publication Statement

Copyright held by author or publisher. User is responsible for all copyright compliance.

This document is currently not available here.

Share

COinS