2009Prosthetics and Orthotics InternationalOpen access

Kinematic Gait Adaptations in Unilateral Transtibial Amputees During Rehabilitation

Cleveland T. Barnett, Natalie Vanicek, Remco Polman, Amanda Hancock, Barbara Brown, Lynne Smith, Ian Chetter

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Abstract

INTRODUCTION: Physiotherapists routinely prescribe the use of two different early walking aids (EWAs) to individuals who have recently undergone unilateral transtibial amputation. No research to date has investigated the kinematic gait patterns of transtibial amputees walking with an EWA during early rehabilitation. The aim of the current RCT study was to compare gait patterns when walking with two different EWAs and whether either EWA provided patients with greater gait benefits. METHODS: Patients were randomly assigned into one of two EWA groups, one group using the Amputee Mobility Aid and another using the Pneumatic Post-Amputation Aid, prior to receiving their functional prosthesis. A 3D motion capture system recorded kinematic data from their first steps up to discharge from rehabilitation. RESULTS: Walking velocity increased significantly (p < 0.01) during rehabilitation. Control of the prosthetic knee improved during rehabilitation in both groups. A lack of conclusive differences between EWAs was noted at discharge from rehabilitation. DISCUSSION: Both groups displayed changes in gait patterns in different gait measures during rehabilitation. However, these changes were not the same for both groups. Gait adaptations occurred soon after walking with a functional prosthesis. CONCLUSION: The results from this study would suggest that neither EWA was more beneficial for gait retraining during rehabilitation.

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INTRODUCTION: Physiotherapists routinely prescribe the use of two different early walking aids (EWAs) to individuals who have recently undergone unilateral transtibial amputation. No research to date has investigated the kinematic gait patterns of transtibial amputees walking with an EWA during early rehabilitation. The aim of the current RCT study was to compare gait patterns when walking with two different EWAs and whether either EWA provided patients with greater gait benefits. METHODS: Patients were randomly assigned into one of two EWA groups, one group using the Amputee Mobility Aid and another using the Pneumatic Post-Amputation Aid, prior to receiving their functional prosthesis. A 3D motion capture system recorded kinematic data from their first steps up to discharge from rehabilitation. RESULTS: Walking velocity increased significantly (p < 0.01) during rehabilitation. Control of the prosthetic knee improved during rehabilitation in both groups. A lack of conclusive differences between EWAs was noted at discharge from rehabilitation. DISCUSSION: Both groups displayed changes in gait patterns in different gait measures during rehabilitation. However, these changes were not the same for both groups. Gait adaptations occurred soon after walking with a functional prosthesis. CONCLUSION: The results from this study would suggest that neither EWA was more beneficial for gait retraining during rehabilitation.

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Available abstract

INTRODUCTION: Physiotherapists routinely prescribe the use of two different early walking aids (EWAs) to individuals who have recently undergone unilateral transtibial amputation. No research to date has investigated the kinematic gait patterns of transtibial amputees walking with an EWA during early rehabilitation. The aim of the current RCT study was to compare gait patterns when walking with two different EWAs and whether either EWA provided patients with greater gait benefits. METHODS: Patients were randomly assigned into one of two EWA groups, one group using the Amputee Mobility Aid and another using the Pneumatic Post-Amputation Aid, prior to receiving their functional prosthesis. A 3D motion capture system recorded kinematic data from their first steps up to discharge from rehabilitation. RESULTS: Walking velocity increased significantly (p < 0.01) during rehabilitation. Control of the prosthetic knee improved during rehabilitation in both groups. A lack of conclusive differences between EWAs was noted at discharge from rehabilitation. DISCUSSION: Both groups displayed changes in gait patterns in different gait measures during rehabilitation. However, these changes were not the same for both groups. Gait adaptations occurred soon after walking with a functional prosthesis. CONCLUSION: The results from this study would suggest that neither EWA was more beneficial for gait retraining during rehabilitation.

Key concepts: Rehabilitation, Gait, Physical medicine and rehabilitation, Kinematics, Amputation, Medicine, Physical therapy, Gait analysis

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