Gait Analysis with an Upper Limb Prosthesis in a Child with Thrombocytopenia-Absent Radius Syndrome

Background/Objectives: Thrombocytopenia-absent radius (TAR) syndrome is a rare genetic disorder characterized by the bilateral absence of the radius and thrombocytopenia, often leading to functional limitations and gait asymmetries. Prosthetic devices are sometimes employed to improve mobility and posture, but their impact on gait mechanics in pediatric patients remains poorly understood. Methods: The methodology used is based on a study that evaluated the gait parameters of a 10-year-old child with TAR syndrome under static and dynamic conditions, both with and without the use of a custom-designed upper limb prosthesis. The analysis focused on assessing the prosthesis's impact on gait symmetry and biomechanics. A key aspect of the methodology involved studying the distribution of pressure forces on the ground during walking using the FreeMed EXTREME Maxi baropodometric platform. Results: Gait analysis demonstrated asymmetries between the left and right feet. In the absence of the prosthesis, the patient exhibited excessive forward loading and uneven pressure distributions. The use of a custom prosthesis, particularly with counterbalancing features, improved gait symmetry but led to increased reliance on the left foot. This foot experienced higher pressures (738-852 g/cm²) and longer ground contact times (690-865 ms) compared to the right foot (619-748 g/cm² and 673-771 ms). The left foot displayed elevated forefoot pressures (61-65%), while the right foot bore weight laterally (66-74%). Conclusions: The custom prosthesis influenced gait mechanics by redistributing plantar pressures and modifying ground contact times, partially improving gait symmetry. However, compensatory strategies, such as increased loading on the left foot, could contribute to musculoskeletal strain over time. Individualized rehabilitation programs and prosthetic designs are essential for optimizing gait mechanics, improving mobility, and minimizing long-term complications in TAR syndrome patients.