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Relationship between level of amputation and compensatory gait strategy
Nikou Nikoumanesh1, Shraddha Sudhir1, Lindsay Slater Hannigan1
1Department of Physical Therapy, University of Illinois Chicago, Chicago, IL, USA.
Clinical Rehabilitation
|November 11, 2025
Summary
Lower limb amputation level affects gait biomechanics. Transfemoral amputation leads to slower walking and increased knee stress, while both amputation types utilize trunk movements for stability, potentially causing back pain.
Area of Science:
- Biomechanics
- Orthopedics
- Rehabilitation Science
Background:
- Lower limb amputation significantly alters gait biomechanics.
- Understanding the impact of amputation level is crucial for targeted rehabilitation.
Purpose of the Study:
- To investigate how transtibial and transfemoral amputation levels influence gait biomechanics and compensatory strategies.
- To compare gait parameters between amputee groups and healthy older adults.
Main Methods:
- Observational laboratory study design.
- Inclusion of participants with unilateral transtibial amputation (8), transfemoral amputation (10), and healthy older adults (11).
- Measurement of gait kinetics and kinematics.
Main Results:
- Transfemoral amputees walked significantly slower than controls (p=0.005).
- Higher knee adduction moment observed in transfemoral vs. transtibial amputees.
- Both amputee groups exhibited trunk lateral flexion towards the intact side for stability, potentially increasing lower back pain risk.
Conclusions:
- Transtibial and transfemoral amputees employ trunk lateral flexion as a compensatory mechanism, which may lead to lower back pain.
- The elevated knee adduction moment in transfemoral amputees suggests an increased risk of knee osteoarthritis.
- Physical therapy and rehabilitation focusing on muscle strength can improve gait mechanics post-amputation.
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