IMPACT OF AMPUTATION LEVEL AND VAULTING ON LOADING PARAMETERS DURING LEVEL GROUND WALKING
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".