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Whole body movement strategies during sit-to-stand and stair ascent in individuals with a lower limb amputation: A systematic review

  • Ludovic Miramand
    Correspondence
    Corresponding author at: Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), 525, boul. Wilfrid-Hamel, Bureau H-0602, Québec G1M 2S8, Canada.
    Affiliations
    Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

    Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
    Search for articles by this author
  • Gabriel Moisan
    Affiliations
    Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

    Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
    Search for articles by this author
  • Vincent Richard
    Affiliations
    Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

    Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
    Search for articles by this author
  • Bradford J. McFadyen
    Affiliations
    Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

    Faculty of Medicine, Département de réadaptation, Université Laval, Québec, Canada
    Search for articles by this author
  • Katia Turcot
    Affiliations
    Centre interdisciplinaire de recherche en réadaptation et intégration sociale (CIRRIS), Québec, Canada

    Faculty of Medicine, Département de kinésiologie, Université Laval, Québec, Canada
    Search for articles by this author

      Highlights

      • Stair gait and sit-to-stand are crucial for individuals with lower limb amputation.
      • Trunk and lower limbs need to be investigated during both tasks.
      • This review identified the most relevant parameters underlying movement strategies.
      • Moment and power show that residual joints compensate for the prosthetic joint.
      • Trunk and lower limb need to be more investigated during both tasks.

      Abstract

      Background

      Individuals with a lower limb amputation use compensatory strategies during essential tasks such as sit-to-stand and stair ascent leading to secondary physical conditions. The ensuing biomechanical parameters outlining the motion strategies they put in place need to be identified and described.

      Methods

      We searched three databases (Embase, IEEE Xplore and PubMed) for articles on the spatiotemporal, the kinematics and the kinetics that compared the amputated, the intact lower limbs, or the trunk of individuals with a unilateral transtibial or transfemoral amputation with the limbs of a control group.

      Findings

      We found twenty articles. During sit-to-stand, individuals with a lower limb amputation increased the trunk inclination angle toward the intact lower limb, explaining higher ground reaction forces and peak knee sagittal power generation. During stair ascent, individuals with a lower limb amputation increased the stance phase duration on the intact lower limb. Moreover, individuals with a lower limb amputation increased both lower limbs hip extension moment and power, and the amputated lower limb knee extension moment. In both tasks, the individuals with a transfemoral amputation presented larger differences than those with transtibial compared to the control group.

      Interpretation

      Both lower limbs intact joint moment and power were increased to compensate for the prosthesis passive joint and to ensure stability. Stair gait studies mainly focused on the lower limbs' biomechanical changes in the sagittal plane, while sit-to-stand studies focused on asymmetries without comparing the lower limbs independently. Better methodological descriptions are essential to enhance the external validity of previous results.

      Keywords

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