Movement asymmetry during low and high demand mobility tasks after dysvascular transtibial amputation |
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| Institution: | 1. Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, California;2. Division of Geriatrics, University of California, San Francisco, San Francisco, California;3. Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado;4. VA Eastern Colorado Geriatric Research, Education, and Clinical Center, university of colorado. Aurora, Colorado;5. San Francisco VA Health Care System, San Francisco, California;6. Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California;7. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States;1. Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China;2. Li Ning Sports Science Research Centre, Beijing, China |
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| Abstract: | BackgroundMovement asymmetries between lower limbs are commonly exhibited by adults after transtibial amputation. However, the degree of movement asymmetry between low- and high-demand functional tasks remains unknown.MethodsKinematic and kinetic data were collected during overground walking (low-demand) and step ascent (high-demand) tasks for two groups: 1) persons with transtibial amputation and 2) healthy matched peers. Analysis of covariance was used to compare sagittal-plane peak knee moment and joint angle (primary) and hip and ankle moments and joint angles, vertical ground reaction force and impulse (secondary).FindingsWithin transtibial amputation group comparisons showed significantly greater between-limb asymmetry in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .05), peak ankle angle (p < .01) and peak ankle moment (p < .01) with the step ascent task compared to overground walking. The transtibial amputation group had greater between-limb asymmetry during step ascent in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .04) and peak ankle angle (p < .01) than healthy matched peers. During overground walking, the transtibial amputation group had greater between-limb asymmetry in peak vertical impulse (p = .05) and peak ankle moment (p < .01) than healthy matched peers.InterpretationMovement asymmetry is increased during step ascent compared to overground walking for adults with transtibial amputation. While the restoration of overground walking is the focus of post-amputation rehabilitation and prosthetic design, higher demand tasks should also be considered to maximize mobility for adults with transtibial amputation. |
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