Bilateral transtibial amputees (BTA) often demonstrate considerable hip-hiking

Bilateral transtibial amputees (BTA) often demonstrate considerable hip-hiking and other gait compensatory movements. This increases the chances of falling and uses a lot of energy. This study hopes to understand the role of upper body motions on BTA gait and balance. Subjects were ask to walk over a level walk way at three different speeds: slowest comfortably possible, normal and comfortable fast. This was completed with first one, then a different prosthetic configuration, always the same on both sides. Data was collected by use of motion capture and compared to able-bodied control subjects. The BTA’s walking speed was so much slower than that of able-bodied controls that only the BTA’s fast walking speed could be used. 

BTA’s showed significantly greater shoulder abduction and lateral trunk flexion ROM. However, exaggerated motion is primarily isolated to the coronal plane and accompanied by greater step width. Due to the trunk movements the centre of mass is often projected towards the edges of the base of support, combined with the BTA’s lack of ankle musculature to compensate, this places the walker at increased risk of falling. The authors conclude that any attempt to reduce the lateral sway would increase stability and reduce fall risk for patients. > From: Major et al., J Gait Post (2013) (Epub ahead of print). All rights reserved to Elsevier B.V.