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Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning
Natalie Vanicek1, Siobhán C Strike2, Remco Polman3
1Department of Sport, Health and Exercise Science, University of Hull, Hull, UK Faculty of Health Sciences, University of Sydney, Sydney, Australia N.Vanicek@hull.ac.uk.
Prosthetics and Orthotics International
|May 22, 2014
Summary
Transtibial amputees who fell descended stairs faster than non-fallers. Using handrails can improve dynamic control during stair descent for amputees with transtibial prostheses.
Area of Science:
- Biomechanics
- Prosthetics
- Gait Analysis
Background:
- Stair negotiation is biomechanically demanding, especially during descent.
- Limited research exists on transtibial amputee (TTA) stair descent biomechanics and falls.
- Stair descent may reveal greater kinematic differences in TTAs with a history of falls compared to level walking.
Purpose of the Study:
- To compare gait kinematics between TTAs who have fallen and those who have not during stair descent.
- To identify kinematic strategies employed by TTAs during step transitions.
Main Methods:
- A cross-sectional study design was employed.
- Six fallers and five non-fallers performed three-step stair descent trials at self-selected speeds.
- Gait kinematics were assessed during the step transition phase.
Main Results:
- Most TTAs preferred leading with their affected limb.
- A 'step-to' strategy was observed in four participants, while the rest used a reciprocal strategy.
- Fallers using a reciprocal strategy walked 44% faster than non-fallers.
- Compensatory pelvic motion occurred due to limited prosthetic plantar flexion.
- The 'step-to' group relied more on handrails and walked slower.
Conclusions:
- Fallers exhibited faster stair descent speeds, utilizing a more challenging 'roll-over' technique.
- Handrail use can enhance dynamic control during stair descent for TTAs.
- Targeted exercises for hip abductor and knee extensor strength, along with proper prosthetic socket fit, are recommended to improve dynamic control and range of motion.