A study published online in the June issue of the Journal of Disability and Rehabilitation compared strategies used by individuals with a transtibial amputation and able-bodied individuals to maintain a stable gait over a variety of non-level walking conditions.
For the study, 24 people, 12 with a unilateral transtibial amputation and 12 able-bodied individuals, walked on a self-paced treadmill in a park-like virtual environment with level and continuous perturbation conditions. Walking stability was quantified by margin-of-stability, step parameters (walking speed, temporal and spatial parameters, and foot clearance), and gait variability (standard deviations for margin-of-stability, step parameters, and root-mean-square of trunk acceleration).
For non-level conditions, able-bodied and transtibial groups had greater root-mean-square of trunk acceleration and walked with a cautious and variable step strategy by changing speed, step width, foot clearance, margin-of-stability, and increasing step variability, the study found. Overall, both groups adopted similar strategies to maintain stable gait over non-level conditions, but the people with amputations were more variable than the able-bodied group, the study found.
The results demonstrated the importance of measuring gait variability, including trunk acceleration and step variability measures, when quantitatively assessing mobility for individuals with a transtibial amputation, and highlight the importance of measuring variability during a comprehensive walking assessment, particularly for active individuals who achieve maximal performance on standard assessments yet report functional limitations in daily living, according to the study.
