Related Experiment Video
Updated: May 16, 2025
Lower-Limb Biomechanical Characteristics Associated with Unplanned Gait Termination Under Different Walking Speeds
Published on: August 25, 2020
Stepping Toward Equity: Understanding Racial Variations in Gait Outcomes of Lower Extremity Amputees
Rajan M Negassa1, Ademide O Young1, Rachel N Rohrich2
1From the Georgetown University School of Medicine, Washington, DC.
Purpose:
Understanding gait as a measure of functionality in patients with nontraumatic lower extremity (LE) amputations across different racial groups is important for limb salvage outcomes. This study assesses gait parameters among Black and White individuals with LE amputations.
Methods:
Adults without open wounds who could safely ambulate without pain were offered inclusion in this study from June 2021 to August 2024. Participants completed a standardized 120-second walk test with wearable sensors.
Results:
Overall, 74 patients provided racial backgrounds and completed a gait test. Amputation type was comparable between Black and White patients. Black patients were significantly younger than White patients (58.8 ± 8.5 vs 65.3 ± 12.6 years, P = 0.009). Average body mass index (31.3 ± 7.2 kg/m2) and Charlson Comorbidity Index (5.4 ± 2.5) were similar between groups (P = 0.591 and P = 0.349, respectively). Rates of diabetes mellitus type II (n = 51, 68.9%) and end-stage renal disease (n = 7, 9.5%) were also similar. Gait speed (0.8 ± 0.2 m/s, P = 0.134), cadence (97.2 ± 11.2 steps/min, P = 0.089), and double limb support (29.3 ± 5.3%, P = 0.079) were comparable. Black patients had significantly lower elevation at midswing (1.4 ± 0.9 vs 2.0 ± 1.8 cm, P = 0.045), longer step duration (0.7 ± 0.1 vs 0.6 ± 0.1 s, P = 0.042), and lower single limb support (34.7 ± 3.1% vs 36.6 ± 2.2%, P = 0.005). On multivariate analysis controlling for comorbidities and socioeconomic factors, race was an independent and significant predictor of lower elevation at midswing (β = -0.039, P = 0.041).
Conclusions:
Our results suggests that Black patients demonstrate a more pathologic gait following LE amputation, which is likely reflective of underlying disparities in access to care, delayed diagnoses, or differences in disease severity. While the influence of race on health outcomes is well-known, this study provides the first objective evidence of a more pathologic gait among Black patients following atraumatic LE amputation. Thus, timely intervention with physical therapy and extended follow-up become even more important in this population.
