The effect of surface inclination and limb on knee loading measures in transtibial prosthesis users.

Only twelve unilateral transtibial prosthesis users and twelve able-bodied controls were studied. The outcomes were knee adduction moment variables, not clinical osteoarthritis outcomes. Participants had no previous osteoarthritis diagnosis and no contralateral limb trauma, so the study does not show what happens in people who already have knee osteoarthritis. All prosthesis users were K-level 3 or 4, so results may not apply to lower functional levels. Walking was done on a computer-controlled treadmill and virtual environment, not real outdoor slopes. The authors note the Bonferroni post hoc test made the comparisons conservative. The intact limb was always the dominant limb in prosthesis users, while able-bodied dominant limb was defined by preferred kicking limb, so limb labels may not match all clinical populations.

The study was funded by the Natural Sciences and Engineering Research Council of Canada. No other funding or conflict statement is provided in the supplied text.

Do not conclude that uphill walking prevents osteoarthritis or that down slope causes osteoarthritis. The study measured knee loading variables in a virtual treadmill in twelve prosthesis users and twelve able-bodied controls, and participants had no previous osteoarthritis diagnosis.