A team of researchers conducted a study to determine if there is a difference in functional gait outcomes between patients with limb injuries who are treated with either transtibial amputations or limb preservation with an Intrepid Dynamic Exoskeletal Orthosis (IDEO™). They conducted a retrospective prognostic study of ten patients with transtibial amputations and ten patients who underwent limb preservation using the IDEO. The two groups were matched by body mass index after excluding for nontraumatic, proximal ipsilateral, contralateral, spine, or traumatic brain injuries. Patients with transtibial amputations were also excluded if they did not have a gait study conducted between six and 12 months after independent ambulation, and patients with limb preservation were excluded if they did not complete the IDEO’s associated Return to Run physical therapy program.
The researchers conducted an observational study of functional outcomes utilizing instrumented gait analysis. The observed outcome measures included spatiotemporal, kinetic (vertical ground reaction force), unified deformable (UD) power, work, and efficiency.
The results indicated that patients who underwent limb preservation walked with a significantly slower cadence (p = 0.036) and spent less time on their affected limbs in stance (p = 0.045), and longer in swing (p = 0.019). Patients who underwent transtibial amputations had significantly increased maximum positive power in both limbs (p = 0.004 and p = 0.029) and increased maximum negative power on the unaffected limb (p = 0.035), they also had significantly increased positive and negative work in the affected limb (p = 0.0009 and p = 0.014) and positive work in the unaffected limb (p = 0.042). There was no significant difference in the kinetic data or efficiency.
Given these results, the study concludes that patients who underwent limb preservation patients spend less time on their affected limb as a percentage of the gait cycle. The UD power demonstrated more dynamic gait in the patients with transtibial amputations, with peak values closer to normative data.
The study, “Limb Salvage With Intrepid Dynamic Exoskeleton Orthosis Versus Transtibial Amputation: A Comparison of Functional Gait Outcomes,” was published online ahead of print in the Journal of Orthpaedic Trauma.
