Assessment of knee flexion in young children with prosthetic knee components using dynamic time warping.

Only five Early Knee children and five typically developing children were analyzed, and only one pair per age group. The results cannot be generalized to all young children with limb loss. All Early Knee children had proximal femoral focal deficiency, so the sample may not represent other causes of limb loss. The comparison limb in a child with one prosthetic leg may not represent the motion that child would have had without limb loss. Age-matched controls introduce variability because neuromotor development changes rapidly at these ages. Stance and swing were analyzed separately, so the study does not show whether the method works well for the entire gait cycle. Individual prosthetic factors can distort curve comparisons. In one child, a high amplitude error was linked to a long residual limb and short prosthetic segment.

The original data collection was funded by The Gerber Foundation. This subsequent analysis was outside the scope of that grant and was not funded. No author conflicts of interest are reported.

Do not read this as evidence that the Early Knee protocol produces more normal gait or reduces adaptations. The study was a small descriptive curve analysis with five prosthetic users and five controls, and it did not test clinical outcomes.