Abstract
Objective
To analyze mediolateral joint powers at the low back during gait among persons with
and without unilateral transfemoral amputation to better understand the functional
contributions of tissues in and around the low back to altered lateral trunk movements
in this population.
Design
Retrospective analysis of biomechanical gait data.
Setting
Gait laboratory.
Participants
Twenty persons with unilateral transfemoral amputation and 20 uninjured controls (N=40).
Interventions
Not applicable.
Main Outcome Measures
Net joint powers, and total generation (+) and absorption (−) energies, at the low
back (L5/S1 spinal level) were analyzed in the frontal plane using inverse dynamics
analyses on over-ground gait data collected at self-selected walking speeds (∼1.3m/s).
Results
Compared with uninjured controls, 4 distinctly larger positive phases of mediolateral
joint power at L5/S1 were evident in persons with transfemoral amputation, occurring
before and after each heel strike. Total generation energies throughout the gait cycle
were also larger (P<.001) among persons with transfemoral amputation (4.8±1.4J) than among uninjured
controls (1.3±0.7J).
Conclusions
Larger positive phases of joint power at L5/S1 in the frontal plane support previous
suggestions that persons with transfemoral amputation use a more active mediolateral
trunk movement strategy, although such an active trunk movement strategy with transfemoral
amputation may contribute to higher metabolic energy expenditures and low back pain
risk.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Control of lateral balance in walking: experimental findings in normal subjects and above-knee amputees.Gait Posture. 2007; 25: 250-258
- Control of whole body balance in the frontal plane during human walking.J Biomech. 1993; 26: 633-644
- Joint torque and energy patterns in normal gait.Biol Cybern. 1978; 29: 137-142
- Three-dimensional motions of trunk and pelvis during transfemoral amputee gait.Arch Phys Med Rehabil. 2008; 89: 87-94
- Prosthetic gait of unilateral transfemoral amputees: a kinematic study.Arch Phys Med Rehabil. 1995; 76: 736-743
- Mechanical energy generation, absorption, and transfer amongst segments during walking.J Biomech. 1980; 13: 845-854
- Three-dimensional joint reaction forces and moments at the low back during over-ground walking in persons with unilateral lower-extremity amputation.Clin Biomech. 2014; 29: 235-242
- Kinetic analysis of the lower limbs during walking: what information can be gained from a three-dimensional model?.J Biomech. 1995; 28: 753-758
- Implications of increased medio-lateral trunk sway for ambulatory mechanics.J Biomech. 2008; 41: 165-170
- Knee and hip internal moments and upper-body kinematics in the frontal plane in unilateral transtibial amputees.Gait Posture. 2013; 37: 436-439
- A preliminary investigation of pelvic obliquity patterns during gait in persons with transtibial and transfemoral amputation.J Rehabili Res Dev. 2000; 37: 1-10
- Transfemoral amputations: the effect of residual limb length and orientation on gait analysis outcome measures.J Bone Joint Surg. 2013; 95: 408-414
- Biomechanics and muscle coordination of human walking, part I: introduction to concepts, power transfer, dynamics and simulations.Gait Posture. 2002; 16: 215-232
- The influence of trunk muscle coactivity on dynamic spinal loads.Spine. 1995; 20: 913-919
- Feasibility of a gait retraining strategy for reducing knee joint loading: increased trunk lean guided by real-time biofeedback.J Biomech. 2011; 44: 943-947
- Integrated electromyogram and oxygen uptake during positive and negative work.J Physiol. 1976; 260: 267-277
Article info
Publication history
Published online: August 04, 2014
Footnotes
Supported by the Center for Rehabilitation Sciences Research, Department of Defense, Defense Health Program (grant no. NF90UG). The views expressed in this article do not necessarily reflect the official policy of the Departments of the Army, Navy, and Defense, nor the U.S. government.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
