Nearly 30 years ago, authors David Winter, PhD, PEng, and Susan Sienko, BSc, challenged some fundamental assumptions associated with prosthetic gait that continue to this day. “Throughout all the amputee-related literature,” they assert, “continuous references are made to variables that establish gait asymmetry. Subsequently, attempts are being made, without scientific justification, to force the amputee to walk more symmetrically.” They continue, “…be cautious about gait retraining protocols which are aimed at improved symmetry based on nothing more than an idea that it would automatically be an improvement.” Summarizing their position, the authors conclude, “It is safe to say that any human system with major structural asymmetries in the neuromuscular skeletal system cannot be optimal when the gait is symmetrical. Rather, a new nonsymmetrical optimal is probably being sought by the amputee with the constraints of his residual system and the mechanics of his prosthesis.”1
