IMPACT OF AMPUTATION LEVEL AND VAULTING ON LOADING PARAMETERS DURING LEVEL GROUND WALKING
Notice bibliographique
Résumé
BACKGROUND: Previous studies show that during level walking, the load on the contralateral side increases with more proximal amputation levels. Furthermore, a typical compensation mechanism, vaulting on the contralateral side, may also influence the load. However, no study has compared the load applied to the contralateral side across more than two different amputation levels. OBJECTIVE: The objectives of this study were to analyze the biomechanical impact of different lower limb amputation levels and vaulting on the load applied to the locomotor system. METHODOLOGY: Gait data from 82 individuals with different amputation levels (44 transtibial (TT), 30 transfemoral (TF), and 8 hip disarticulation (HD)) were retrospectively analyzed in this study. Peak knee adduction, flexion and extension moments, vertical ground reaction force peaks, and force rates were statistically analyzed between different amputation levels and between two groups “TF with vaulting” and “TF without vaulting”. FINDINGS: As the level of amputation increases, walking speed decreases and asymmetry of stance duration increases. TF individuals with vaulting tend to walk faster than those without vaulting. The first peak of vertical ground reaction forces, the peak knee adduction and extension moments increase, and the peak knee flexion moments decrease with higher amputation level. The higher the amputation level, the curve of the vertical ground reaction force becomes significantly steeper during the first 5% of the gait cycle (GC). The first peak of ground reaction forces, the knee flexion, extension and adduction moments tend to be higher in TF individuals with vaulting. CONCLUSION: In summary, a higher lower limb amputation level can increase loading on the contralateral limb and contribute to a higher incidence of vaulting during gait. The effect of vaulting as a compensation pattern leads to an additional increase in contralateral limb loading. Layman's Abstract Gait characteristics in people using lower limb prostheses deviate from normal gait patterns in individuals without amputation. Furthermore, some people with amputation rise onto the toes of their intact side (a movement known as vaulting) as a compensatory mechanism during walking, which helps them clear the ground on the prosthetic side. In people with lower limb amputation, the load applied to the intact side during level walking is higher compared to able-bodied individuals, and it increases as the level of amputation progresses from below the knee to hip disarticulation. No previous study has compared the load applied to the intact side across more than two different amputation levels. The aims of the present study were to analyze the influence of the amputation level and of vaulting on the load applied to the lower limb. Therefore, we analyzed previously collected gait data from 82 individuals with amputation (44 transtibial, 30 transfemoral, and 8 with hip disarticulation). As the level of amputation increases, walking speed decreases and individuals tend to spend more time on the intact side than the prosthetic side during each gait cycle. Individuals with transfemoral amputation who use vaulting as a compensatory movement tend to walk faster than those who do not use this strategy and experience higher forces on the intact limb. As the level of amputation increases, most of the forces applied to the body during level walking also increase. Furthermore, vaulting is more common in individuals with higher amputation levels. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/44416/33698 How To Cite: Pröbsting E, Schmalz T, Bellmann M. Impact of amputation level and vaulting on loading parameters during level ground walking. Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 1, No. 2. Https://doi.org/10.33137/cpoj.v8i1.44416 Corresponding Author: Eva Pröbsting, Dipl.-Ing (FH)Affiliation: Clinical Research and Services, Research Biomechanics, Ottobock SE & Co. KGaA, Göttingen, Germany.E-Mail: Eva.Proebsting@ottobock.deORCID ID: https://orcid.org/0000-0002-6349-2992
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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