Document Detail

Mechanisms of Gait Asymmetry Due to Push-Off Deficiency in Unilateral Amputees.
MedLine Citation:
PMID:  25222950     Owner:  NLM     Status:  Publisher    
Unilateral lower-limb amputees exhibit asymmetry in many gait features, such as ground force, step time, step length, and joint mechanics. Although these asymmetries result from weak prosthetic-side push-off, there is no proven mechanistic explanation of how that impairment propagates to the rest of the body. We used a simple dynamic walking model to explore possible consequences of a unilateral impairment similar to that of a transtibial amputee. The model compensates for reduced push-off work from one leg by performing more work elsewhere, for example during the middle of stance by either or both legs. The model predicts several gait abnormalities, including slower forward velocity of the body center-of-mass (COM) during intact-side stance, greater energy dissipation in the intact side, and more positive work overall. We tested these predictions with data from unilateral transtibial amputees (N = 11) and non-amputee control subjects (N = 10) walking on an instrumented treadmill. We observed several predicted asymmetries, including forward velocity during stance phases and energy dissipation from the two limbs, as well as greater work overall. Secondary adaptations, such as to reduce discomfort, may exacerbate asymmetry, but these simple principles suggest that some asymmetry may be unavoidable in cases of unilateral limb loss.
Peter Gabriel Adamczyk; Arthur D Kuo
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-12
Journal Detail:
Title:  IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society     Volume:  -     ISSN:  1558-0210     ISO Abbreviation:  IEEE Trans Neural Syst Rehabil Eng     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-9-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101097023     Medline TA:  IEEE Trans Neural Syst Rehabil Eng     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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