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Factors affecting gait symmetry in unilateral transtibial prosthesis users: Surface, speed, and slope
Ali İmran Yalçın1,2, Semra Topuz1,2, Gül Yazıcıoğlu3
1Movement Analysis Laboratory of the Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
Background:
In individuals with lower extremity amputation, a certain degree of gait asymmetry is biomechanically unavoidable and has been associated with reduced energy efficiency, secondary musculoskeletal complications, and diminished quality of life. The aim of this study was to investigate the effects of surface type, walking speed, and slope on gait symmetry in unilateral transtibial prosthesis users.
Study Design And Methods:
: Ten male individuals with unilateral transtibial amputation (mean age 36.5 ± 10.3 years) who had been using prostheses for at least 1 year participated. Participants walked under 7 conditions varying in surface type, speed, and slope. Lower extremity spatiotemporal parameters and joint angular kinematics were recorded using an inertial motion analysis system. Symmetry indices were calculated for each parameter and analyzed.
Results:
Knee frontal-plane range of motion (RoM) was more asymmetrical on uneven ground than on level ground (p=0.004). Step length was more asymmetrical during slow walking compared with fast walking (p=0.015). Swing phase duration (p=0.002) and ankle sagittal-plane RoM (p=0.002) were more asymmetrical during ramp ascent.
Conclusion:
Changes in walking surface, speed, or slope affect gait symmetry in unilateral transtibial prosthesis users, with effects varying by condition. The findings revealed that gait asymmetry in this population is not a fixed characteristic but a dynamic, condition-dependent response to the demands of the walking environment.
