Investigation of hip joint kinematics at different walking speeds in unilateral transtibial amputees

Abstract

Purpose: The study was planned to examine hip joint kinematics in 3-dimesional at different walking speeds of individuals with unilateral transtibial amputation. Method: Twenty individuals, including unilateral transtibial amputation (n=10) and healthy individuals (n=10), were included in the study. The hip joint kinematics of the individuals were evaluated with a 3-dimensional motion analysis system during walking at normal speed, 80% and 120% of normal speed on the treadmill. Results: As a result of the study, there was a difference in the measurements made in the sagittal plane between the groups at different walking speeds of the individuals (p<0.05). It was observed that hip movements in the prosthetic extremity in amputees were higher than the unaffected extremity in the sagittal plane (p<0.05). Conclusion: Hip movements in the sagittal plane vary in direct proportion to walking speed. The asymmetry between the extremities continues at different speeds. For this reason, it was concluded that applications for symmetrical walking at different speeds should be included in rehabilitation programs in amputee rehabilitation.

Keywords

• Amputees
• Gait
• Kinematics
• Hip

Unilateral transtibial amputelerde farklı yürüyüş hızlarında kalça eklem kinematiğinin incelenmesi

Abstract

Amaç: Çalışma unilateral transtibial amputasyonu olan bireylerin farklı yürüyüş hızlarında kalça eklem kinematiklerinin 3 boyutlu olarak incelenmesi amacıyla planlandı. Yöntem: Çalışmaya unilateral transtibial amputasyonu olan (n=10) ve sağlıklı bireyler(n=10) olmak üzere 20 birey dahil edildi. Bireylerin kalça eklem kinematikleri yürüme bandı üzerinde normal hızda, bu hızın %80’inde ve %120’sinde yapılan yürüyüşlerde 3 boyutlu hareket analiz sistemi ile değerlendirildi. Bulgular: Çalışma sonucunda bireylerin farklı yürüyüş hızlarında ve bu hızlarda gruplar arasında sagittal düzlemde yapılan ölçümlerde fark bulundu (p<0,05). Ampute bireylerde protezli ekstremitede kalça hareketlerinin sagittal düzlemde etkilenmemiş ekstremiteden fazla olduğu görüldü (p<0,05). Sonuç: Sagittal düzlemdeki kalça hareketleri yürüyüş hızı ile doğru orantılı olarak değişkenlik göstermektedir. Ekstremiteler arasındaki asimetri farklı hızlarda da devam etmektedir. Bu nedenle ampute rehabilitasyonunda farklı hızlarda da simetrik yürüyüşe yönelik uygulamaların rehabilitasyon programlarına dahil edilmesi gerektiği görüşüne varıldı.

Keywords

• ampute
• yürüyüş
• kinematik
• kalça

References

1. 1. Eshraghi A, Abu Osman NA, Karimi M, Gholizadeh H, Soodmand E, Abas WABW. Gait biomechanics of individuals with transtibial amputation: effect of suspension system. PloS One. 2014;9:e96988.
2. 2. Staats T. The rehabilitation of the amputee in the developing world: a review of the literature. Prosthet Orthot Int. 1996;20:45-50.
3. 3. Soares ASOdC, Yamaguti EY, Mochizuki L, Amadio AC, Serrão JC. Biomechanical parameters of gait among transtibial amputees: a review. Sao Paulo Med J. 2009;127:302-309.
4. 4. Kovač I, Medved V, Ostojić L. Spatial, temporal and kinematic characteristics of traumatic transtibial amputees' gait. Coll Antropol. 2010;34(1):205-213.
5. 5. Grumillier C, Martinet N, Paysant J, André J-M, Beyaert C. Compensatory mechanism involving the hip joint of the intact limb during gait in unilateral trans-tibial amputees. J Biomech. 2008;41:2926-2931.
6. 6. Yoo S. Complications following an amputation. Phys Med Rehabil Clin. 2014;25:169-178.
7. 7. Rueda FM, Diego IMA, Sánchez AM, Tejada MC, Montero FMR, Page JCM. Knee and hip internal moments and upper-body kinematics in the frontal plane in unilateral transtibial amputees. Gait Posture. 2013;37:436-439.
8. 8. Ajibade A, Akinniyi O, Okoye C. Indications and complications of major limb amputations in Kano, Nigeria. Ghana Med J. 2013;47:185.

9. 9. Lloyd CH, Stanhope SJ, Davis IS, Royer TD. Strength asymmetry and osteoarthritis risk factors in unilateral trans-tibial, amputee gait. Gait Posture. 2010;32:296-300.
10. 10. Struyf PA, van Heugten CM, Hitters MW, Smeets RJ. The prevalence of osteoarthritis of the intact hip and knee among traumatic leg amputees. Arch Phys Med Rehabil. 2009;90:440-446.
11. 11. Tesio L, Lanzi D, Detrembleur C. The 3-D motion of the centre of gravity of the human body during level walking. II. Lower limb amputees. Clin Biomech. 1998;13:83-90.
12. 12. Kim B, Youm C, Park H, Lee M, Noh B. Characteristics of Gait Variability in the Elderly While Walking on a Treadmill with Gait Speed Variation. Int J Environ Res Public Health. 2021;18:4704.
13. 13. Krasovsky T, Lamontagne A, Feldman AG, Levin MF. Effects of walking speed on gait stability and interlimb coordination in younger and older adults. Gait Posture. 2014;39:378-385.
14. 14. Zhang J-T, Novak AC, Brouwer B, Li Q. Concurrent validation of Xsens MVN measurement of lower limb joint angular kinematics. Physiol Meas. 2013;34:N63.
15. 15. Robertson DGE, Caldwell GE, Hamill J, Kamen G, Whittlesey S. Research methods in biomechanics. Human kinetics; 2013.
16. 16. Bruening DA, Frimenko RE, Goodyear CD, Bowden DR, Fullenkamp AM. Sex differences in whole body gait kinematics at preferred speeds. Gait Posture. 2015;41:540-545.
17. 17. Vanicek N, Strike S, McNaughton L, Polman R. Gait patterns in transtibial amputee fallers vs. non-fallers: Biomechanical differences during level walking. Gait Posture. 2009;29:415-420.
18. 18. Fukuchi CA, Fukuchi RK, Duarte M. Effects of walking speed on gait biomechanics in healthy participants: a systematic review and meta-analysis. Syst Rev. 2019;8:153.
19. 19. Isakov E, Burger H, Krajnik J, Gregoric M, Marincek C. Influence of speed on gait parameters and on symmetry in transtibial amputees. Prosthet Orthot Int. 1996;20:153-158.
20. 20. Liu Y, Lu K, Yan S, Sun M, Lester DK, Zhang K. Gait phase varies over velocities. Gait Posture. 2014;39:756-760.
21. 21. Wilken JM, Rodriguez KM, Brawner M, Darter BJ. Reliability and minimal detectible change values for gait kinematics and kinetics in healthy adults. Gait Posture. 2012;35:301-307.
22. 22. Hanlon M, Anderson R. Prediction methods to account for the effect of gait speed on lower limb angular kinematics. Gait Posture. 2006;24:280-287.
23. 23. Gates DH, Darter BJ, Dingwell JB, Wilken JM. Comparison of walking overground and in a Computer Assisted Rehabilitation Environment (CAREN) in individuals with and without transtibial amputation.J Neuroeng Rehabil. 2012;9:1-10.