Lower-extremity inter-joint coordination variability in active individuals with transtibial amputation and healthy males during gait.

This study was aimed to compare the variability of inter-joint coordination in the lower-extremities during gait between active individuals with transtibial amputation (TTAs) and healthy individuals (HIs). Fifteen active male TTAs (age: 40.6 ± 16.24 years, height: 1.74 ± 0.09 m, and mass: 71.2 ± 8.87 kg) and HIs (age: 37.25 ± 13.11 years, height: 1.75 ± 0.06 m, and mass: 74 ± 8.75 kg) without gait disabilities voluntarily participated in the study. Participants walked along a level walkway covered with Vicon motion capture system, and their lower-extremity kinematics data were recorded during gait. The spatiotemporal gait parameters, lower-extremity joint range of motion (ROM), and their coordination and variability were calculated and averaged to report a single value for each parameter based on biomechanical symmetry assumption in the lower limbs of HIs. Additionally, these parameters were separately calculated and reported for the intact limb (IL) and the prosthesis limb (PL) in TTAs individuals. Finally, a comparison was made between the averaged values in HIs and those in the IL and PL of TTAs subjects. The results showed that the IL had a significantly lower stride length than that of the PL and averaged value in HIs, and the IL had a significantly lower knee ROM and greater stance-phase duration than that of HIs. Moreover, TTAs showed different coordination patterns in pelvis-to-hip, hip-to-knee, and hip-to-ankle couplings in some parts of the gait cycle. It concludes that the active TTAs with PLs walked with more flexion of the knee and hip, which may indicate a progressive walking strategy and the differences in coordination patterns suggest active TTA individuals used different neuromuscular control strategies to adapt to their amputation. Researchers can extend this work by investigating variations in these parameters across diverse patient populations, including different amputation etiologies and prosthetic designs. Moreover, Clinicians can use the findings to tailor rehabilitation programs for TTAs, emphasizing joint flexibility and coordination.

Lower limb joint angles and their variability during uphill walking.

BACKGROUND: Adaptation of the walking pattern to uphill walking demands immediate coordination between the lower limb segments. Nonetheless, knowledge about individual joints' responses and variability in response to the new slope angles are missing. AIMS: This study investigated the impacts of uphill walking on the ankle, the knee and the hip joints angles and their variability. METHODS: Twenty-three collegiate athletes (age: 22.04 ± 3.43years, body mass: 62.14 ± 9.26Kg, height: 168.29 ± 7.06 cm) walked on an inclined treadmill at 0 ° (level walking -LW), 5 ° (low-slope-walking -LSW), and 10 ° (high-slope-walking -HSW) slopes at their preferred walking speed (4.2 ± 0.51 km.h-1). The ankle, knee and hip joints angles and their variability (standard deviations) were calculated and analysed throughout the gait cycles in LW, LSW, and HSW. RESULTS: Repeated measure ANOVA portrayed significant differences between the ankle joint angles in sagittal (p < .001, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .005, .14 < ηp2>.01) planes. In the knee joint, the sagittal (p < .001, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .05, ηp2>.14) angles were significantly different (p < 0.05). Similarly, in the hip joint, the sagittal (p < .05, ηp2>.14), frontal (p < .05, ηp2>.14), and transverse (p < .05, ηp2>.14) angles were significantly different. Ankle angle variability was significantly different in sagittal (P < .001, ηp2>.14), frontal (p = .002, ηp2>.14) and horizontal (P < .001, ηp2>.14) planes, as well as knee joint angle variability in sagittal, frontal and horizontal planes p < 0.001, ηp2>.14. The hip joint variability was considerably different in sagittal (p = .031, ηp2>.14) and horizontal (p < .05, ηp2>.14) planes. CONCLUSION: Uphill walking involves further modifications in the ankle, knee and hip joints angle to adjust the whole-body movements to a new slope. This adjustment resulted in a firm base of support, provided by the ankle, to regulate the knee and hip joints modifications. Nevertheless, it caused less ankle movement variability and could end up with injuries over long-term uphill walking.