Original article
Three-Dimensional Motions of Trunk and Pelvis During Transfemoral Amputee Gait

https://doi.org/10.1016/j.apmr.2007.08.136Get rights and content

Abstract

Goujon-Pillet H, Sapin E, Fodé P, Lavaste F. Three-dimensional motions of trunk and pelvis during transfemoral amputee gait.

Objectives

To identify characteristics of upper-body kinematics and torque transmission to the ground during locomotion in a group of patients with transfemoral amputation as compared with a group of asymptomatic subjects; and to investigate the influence of walking velocity and residual limb length on several characteristics of upper-body motion.

Design

Three-dimensional gait analysis with an optoelectronic device.

Setting

Gait laboratory.

Participants

Twenty-seven patients with transfemoral amputation and a control group of 33 nondisabled subjects.

Interventions

Not applicable.

Main Outcome Measures

Three-dimensional kinematics of the pelvis and the thorax and ground reaction force for amputees and control subjects.

Results

For subjects with transfemoral amputation, it was observed that upper-body angular ranges of motion (ROMs) increased globally as walking velocity decreased. For these subjects, specific patterns of pelvic rotation and torque transmission by the lower limbs around the vertical axis were found. The counter-rotation between the pelvic and scapular girdles was reduced. This reduction proved to be linked with the decrease of walking velocity. Walking velocity also affected all the parameters describing the motion of upper body. Pelvic ROM increased with the length of the limb decreasing.

Conclusions

The huge differences found between subjects with and without amputation suggest that the motion of the upper body must be considered to enhance gait.

Section snippets

Participants

We included 27 patients with transfemoral amputation (group A) and 33 asymptomatic subjects (control group) in this study. Patients’ mean age was 50.9 years (range, 28–73y). None used an assistive device during gait. Each patient’s prosthetic fitting and medical follow-up were done at the Centre d’Etudes et de Recherche pour l’Appareillage des Handicapés (CERAH). Residual limb length was measured by a physician between the anterosuperior iliac spine of the pelvis and the extremity of the

Comparison Between Groups

Figure 2 highlights the specific patterns of the pelvic motion of transfemoral amputees (group A). The 3 graphs show the comparison between subjects with and without amputation. The curves represent the evolution of pelvic angular position in the 3 planes of space during 1 gait cycle of a lower limb. On each graph, corridors (mean curve ±1 SD) are drawn. For asymptomatic subjects, we checked that curves are the same for gait cycles of right and left limbs. We chose to represent the mean curves

Discussion

This study sought to identify kinematic characteristics of upper-body motion for transfemoral amputees. Particularly, 1 purpose was to investigate simultaneously the relationships between the pelvic and the scapular girdles in the transverse plane and the torque transmitted through the lower limbs to the ground. To achieve this goal, the present work relied on a population of 27 transfemoral amputees and 33 asymptomatic subjects.

The first hypothesis was that the pelvis and the thorax exhibit

Conclusions

This study highlights the main characteristics of upper-body kinematics during the gait of people with transfemoral amputation. The analysis was conducted on a sample of 27 amputees and 33 asymptomatic subjects, which implies a good reliability of the results.

The conclusions that can be drawn concerning amputees compared with nonamputees are as follows: (1) the pelvis is globally less stable for transfemoral amputees, particularly in the sagittal plane; (2) pelvic tilt patterns are opposite;

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