Gait asymmetry and a high incidence of lower back pain are often typical for people with unilateral lower-limb amputations. While a common therapeutic objective is to improve gait symmetry, it is unknown whether better gait symmetry would reduce lower back pain risk. To begin investigating this clinical question, researchers examined a preexisting dataset to explore whether L5/S1 vertebral joint forces in people with unilateral lower-limb amputations can be improved with better symmetry.
L5/S1 compression and resultant shear forces were estimated in each of the five participants with a lower-limb amputation with an OpenSim musculoskeletal model during different levels of guided gait asymmetry. The amount of asymmetry was defined by bilateral stance times and guided via real-time feedback.
The forces found at the theoretical lowest force and during the 0 percent asymmetry level were compared to forces at preferred levels of asymmetry and to those from an able-bodied group of five individuals.
Results of the study indicated that the forces for the people with unilateral lower-limb amputation group at the preferred level of asymmetry were not different then at their 0 percent asymmetry condition, theoretical lowest L5/S1 forces, or the able-bodied group.
Their preliminary results challenged the premise that restoring symmetric gait in people with unilateral lower-limb amputation could reduce risk of lower back pain, the researchers concluded.
The study, “Are lower back demands reduced by improving gait symmetry in unilateral transtibial amputees?,” was published in the journal Clinical Biomechanics.