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Knee Torque and Gait Performance in Veteran Amputees: Biomechanical Insights Into Intact Limb Injury Risk.

Jose M Frias-Bocanegra1, Natalie L Egginton2, Daniel T Fong1

  • 1School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, United Kingdom.

Military Medicine
|September 23, 2025
PubMed
Summary

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Veteran amputees show preserved strength but require improved gait training to prevent future musculoskeletal injuries. This study quantifies gait and strength to inform better rehabilitation for long-term health.

Area of Science:

  • Biomechanics and rehabilitation science.
  • Study of veteran amputee population.
  • Musculoskeletal health and aging.

Background:

  • Veteran amputees face risks of comorbidities with aging.
  • Limited research quantifies gait and strength in veteran amputees.
  • Need for studies on gait parameters and lower limb strength in relation to musculoskeletal injury risk.

Purpose of the Study:

  • To quantify key gait parameters and lower limb strength in veteran amputees.
  • To examine the relationship between gait, strength, and potential indicators of musculoskeletal injuries.
  • To identify areas for improved rehabilitation strategies in veteran amputees.

Main Methods:

  • Utilized 3D motion capture and force plates for gait analysis during a 6-minute walk test (6MWT).

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  • Measured peak knee extension/flexion isometric torque and Hamstring:Quadriceps (H:Q) ratio using an isokinetic dynamometer.
  • Matched unilateral transtibial (UTT) and unilateral transfemoral (UTF) amputee cohorts with able-bodied controls.

    • Main Results:

    • UTT amputees exhibited a below-recommended H:Q torque ratio, indicating potential gait imbalance.
    • No significant differences in intact knee torques were observed between cohorts 12.5 years post-injury.
    • UTF amputees showed significantly lower walking speed and distance during the 6MWT compared to controls and UTT amputees.
    • Kinetic asymmetries were noted in both amputee groups during the latter stages of the 6MWT, suggesting potential knee joint stress.

    Conclusions:

    • UK veteran amputees demonstrate strong intact limb strength post-rehabilitation.
    • Submaximal exercises reveal opportunities to enhance amputee gait functionality.
    • Individualized rehabilitation focusing on quality of life may delay the onset of musculoskeletal comorbidities in veteran amputees.