Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective.
Cristiano De Marchis, Simone Ranaldi, Tiwana Varrecchia and 7 others
PMID 36189078WHAT IT FOUND
People with transfemoral amputation show specific gait alterations, including reduced energy recovery and increased pelvic obliquity, compared to transtibial amputees and controls.
More advanced microprocessor knees reduce these compensatory movements. Multimodal measurement is needed to fully understand prosthetic gait.
Key findings
01Subjects with transfemoral amputation have a lower ability to recover mechanical energy at each walking step compared to speed-matched healthy controls, regardless of the type of prosthesis.
02Pelvic obliquity on the prosthetic side is the only variable related to lower energy recovery in transfemoral amputation, and more advanced prosthetic knees like the Genium require less compensation in this parameter.
03The most critical phase in the gait of people with transfemoral amputation is the second double support phase, corresponding to the weight transfer from the sound limb to the prosthetic one.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a perspective article summarizing previously published data, not a new primary study. The analysis relies on indirect interpretations of the underlying studies' results. Sample sizes for specific prosthesis subgroups in the underlying studies were small (e.g., n=7-17 for TFA groups). The studies included only experienced prosthesis users, so findings may not apply to new amputees during early rehabilitation.
Declared interests
Funded by the Italian Worker's Compensation Authority (INAIL). The authors declare no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret this as evidence that advanced prosthetic knees definitively improve clinical outcomes or reduce back pain. The paper notes these are indirect interpretations from a summary of previous studies, and the link between reduced pelvic obliquity and lower back pain risk is a hypothesis derived from the data, not a directly measured clinical outcome.