Highlights
- •Gait adaptations during cross-slopes were primarily in the lower extremities.
- •Gait adaptations were largely similar for those with and without a transtibial amputation.
- •An asymmetric gait may help to minimize upper body motion during cross-slopes.
Abstract
Background
This research was conducted to better understand compensatory strategies during cross-slope
walking for adults with and without a unilateral transtibial amputation.
Methods
Fourteen individuals with unilateral transtibial amputation and 14 individuals with
no lower limb amputation participated in this study. Motion and force data were captured
while participants walked on a treadmill in a virtual reality environment for level
and ± 5° cross slopes. Temporal-spatial parameters, kinematics (ankle, knee, hip,
pelvis, trunk), and ground reaction forces were examined.
Findings
Compared to level, participants had similar step width but slightly longer steps for
top-cross-slope and slightly shorter steps for bottom-cross-slope. Top-cross-slope
required a more flexed limb with ankle eversion, and bottom-cross-slope required a
more extended limb with ankle inversion. Participants had similar lateral pelvis and
trunk motion for all walking conditions, but slightly more anterior trunk lean for
top cross-slope with more anterior trunk lean observed for individuals with a lower
limb amputation than without lower limb amputation. Participants with a lower limb
amputation compensated for limited prosthetic ankle-foot dorsiflexion on the top-cross-slope
by increasing prosthetic side hip flexion, reducing intact ankle/knee flexion, and
increasing intact push-off force.
Interpretation
Gait adaptations during cross-slope walking were primarily in the lower extremities
and were largely similar for those with and without a transtibial amputation. The
information presented in this paper provides a better understanding of gait strategies
adopted during cross-slope walking and can guide researchers and industry in prosthetic
development.
Keywords
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Article info
Publication history
Published online: July 18, 2022
Accepted:
July 15,
2022
Received:
March 30,
2022
Footnotes
☆All authors were fully involved in the study and preparation of the manuscript and the material within has not been and will not be submitted for publication elsewhere.
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
