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Lumbopelvic coordination while walking in service members with unilateral lower limb loss: Comparing variabilities
Joseph G Wasser1, Julian C Acasio1, Ross H Miller2
1Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda 20814, USA; Henry M. Jackson Foundation, for the Advancement of Military Medicine, 6720A Rockledge Dr, Bethesda 20817, USA.
Background:
Continuous relative phase and vector coding are two common approaches for quantifying lumbopelvic coordination and variability. Evaluating the application of such methodologies to the lower limb loss population is important for better understanding reported asymmetrical movement dynamics of the lumbopelvic region.
Research Question:
How do coordination variabilities derived from trunk-pelvic coupling angles and continuous relative phases compare among individuals with and without unilateral lower limb loss walking at self-selected speeds?
Methods:
Full-body kinematics were obtained from thirty-eight males with unilateral lower limb loss (23 transtibial and 15 transfemoral) and fifteen males without limb loss while walking along a 15 m walkway. Coordination variabilities were derived from trunk-pelvic coupling angles and continuous relative phases and compared using a multivariate approach, as well as in unilateral outcome measures between control participants and participants with lower limb loss.
Results:
Overall, tri-planar measures of continuous relative phase variability were 19-43% larger compared to coupling angle variabilities for individuals without limb loss and individuals with transtibial limb loss. Individuals with transfemoral limb loss had 27% and 31% larger sagittal and transverse variabilities from continuous relative phases compared to coupling angles, respectively. During both prosthetic and intact limb stance, individuals with transtibial limb loss had 19-35% greater tri-planar measures of continuous relative phase variability compared to coupling angle variabilities. During intact stance phase, tri-planar measures of continuous relative phase variability were 27%- 42% larger compared to coupling angle variabilities for individuals without limb loss.
Significance:
While both methods provide valid estimates of lumbopelvic movement variability during gait, continuous relative phase variability may provide a more sensitive estimate in the lower limb loss population capturing velocity-specific motions of the trunk and pelvis.
