Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 8 , Pages 1115-1122 , August 2006

High Failure Rates When Avoiding Obstacles During Treadmill Walking in Patients With a Transtibial Amputation

  • Cheriel J. Hofstad, MSc

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
    • Institute for Fundamental and Clinical Human Movement Sciences, The Netherlands.
    • Corresponding Author InformationReprint requests to Cheriel J. Hofstad, MSc, Sint Maartenskliniek Research Development & Education, PO Box 9011, 6500 GM Nijmegen, The Netherlands
  • ,
  • Harmen van der Linde, MD, PhD

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
  • ,
  • Bart Nienhuis, Med Eng

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
  • ,
  • Vivian Weerdesteyn, MSc

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
    • Institute for Fundamental and Clinical Human Movement Sciences, The Netherlands.
  • ,
  • Jacques Duysens, MD, PhD

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
    • Department of Rehabilitation Medicine, University Medical Center St. Radboud, Nijmegen, The Netherlands
    • Institute for Fundamental and Clinical Human Movement Sciences, The Netherlands.
  • ,
  • Alexander C. Geurts, MD, PhD

      Affiliations

    • Sint Maartenskliniek Research Development & Education, Nijmegen, The Netherlands
    • Department of Rehabilitation Medicine, University Medical Center St. Radboud, Nijmegen, The Netherlands
    • Institute for Fundamental and Clinical Human Movement Sciences, The Netherlands.

  • Image Result

    The positions of the toe marker and the obstacle are shown after transformation from treadmill walking to overground walking. The bold line illustrates the actual trajectory of the toe marker; the thi

    The positions of the toe marker and the obstacle are shown after transformation from treadmill walking to overground walking. The bold line illustrates the actual trajectory of the toe marker; the thin line illustrates the extrapolated trajectory of the toe marker that would have occurred without an avoidance reaction. The grey rectangle represents the obstacle, which started to fall at 0ms. The duration between this moment and the moment at which the extrapolated toe would have crossed the front of the obstacle is defined as the available response time. In this trial, the available response time was 350ms and a short step strategy was used to avoid the obstacle. Abbreviation: ART, available response time.

  • Image Result
    Mean ± SD (A) step length, (B) relative stance time, and (C) maximum vertical heel displacement for the left leg of the control group, and for the prosthetic and nonprosthetic legs of the amputation g

    Mean ± SD (A) step length, (B) relative stance time, and (C) maximum vertical heel displacement for the left leg of the control group, and for the prosthetic and nonprosthetic legs of the amputation group. *P<.05.

  • Image Result
    (A) Mean ± SD percentage of failures for the left leg of the control group and for the nonprosthetic and prosthetic legs of the amputation group. (B) Failure rates per available response time category

    (A) Mean ± SD percentage of failures for the left leg of the control group and for the nonprosthetic and prosthetic legs of the amputation group. (B) Failure rates per available response time category for the left leg of the control group and for the 2 legs of the amputation group.

  • Image Result
    The mean percentage of total shortening (left side of the graphs) and lengthening steps (right side of the graphs) for the control leg (C) and for the nonprosthetic (NP) and prosthetic (P) legs. The b

    The mean percentage of total shortening (left side of the graphs) and lengthening steps (right side of the graphs) for the control leg (C) and for the nonprosthetic (NP) and prosthetic (P) legs. The black parts of the bars indicate the mean percentages of failures. (A) All available response time categories (range, 150–800ms); (B) the trials with available response times higher than 250ms; and (C) the trials with available response times lower than 250ms.

  • Image Result
    A scatterplot of the failure rate against the time since amputation for the prosthetic leg of the amputation group.

    A scatterplot of the failure rate against the time since amputation for the prosthetic leg of the amputation group.

 Supported by the European Union (grant no. QLK6-CT-2002-00151: Eurokinesis).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(06)00355-8

doi: 10.1016/j.apmr.2006.04.009

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 8 , Pages 1115-1122 , August 2006