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Updated: Feb 17, 2026
Lower-Limb Biomechanical Characteristics Associated with Unplanned Gait Termination Under Different Walking Speeds
Published on: August 25, 2020
Walking speed differentially alters spinal loads in persons with traumatic lower limb amputation
Brad D Hendershot1, Iman Shojaei2, Julian C Acasio3
1DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA; Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Individuals with lower limb amputation (LLA) experience higher spinal loads during walking, especially at faster speeds. This increased load may elevate their risk of developing low back pain over time.
Area of Science:
- Biomechanics
- Musculoskeletal Health
- Prosthetics and Orthotics
Background:
- Persons with lower limb amputation (LLA) report altered trunk/pelvic motion contributing to low back pain.
- Previous studies link larger trunk motions in LLA during walking to increased spinal loads.
- Understanding the impact of walking speed on spinal loads in LLA is crucial due to the necessity of speed modulation in daily activities.
Purpose of the Study:
- To investigate the influence of walking speed on spinal loads at the L5/S1 level in individuals with transfemoral and transtibial amputations compared to uninjured controls.
- To quantify differences in spinal loads during level-ground walking at self-selected and controlled speeds.
Main Methods:
- Collected 3D trunk-pelvic kinematics during walking at self-selected, ~1.0 m/s, and ~1.4 m/s speeds.
- Utilized a kinematics-driven, non-linear finite element model of the lower back to estimate L5/S1 spinal loads (compressive and shear).
- Included 78 participants: 26 transfemoral amputation, 26 transtibial amputation, and 26 uninjured controls.
Main Results:
- Despite slower self-selected walking speeds (~0.21 m/s), individuals with transfemoral amputation exhibited 8-14% higher spinal loads compared to controls.
- Across all participants, peak compressive, mediolateral, and anteroposterior shear loads increased with walking speed.
- At the fastest controlled speed, LLA participants showed significantly greater increases in spinal loads (24-84% compressive, 29-77% shear) relative to controls.
Conclusions:
- Elevated spinal loads in individuals with LLA, particularly at faster walking speeds, may contribute to their increased risk of low back pain.
- Repeated exposure to these higher loads over time could exacerbate the risk of developing low back pain.
- Further research is needed to analyze other activities and tissue-level responses to fully characterize risk in daily life.
