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Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses
BACKGROUND: In this paper we use multivariate statistical techniques to gain insights into how adaptive gait involving obstacle crossing is regulated in lower-limb amputees compared to able-bodied controls, with the aim of identifying underlying characteristics that differ between the two groups and...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751839/ https://www.ncbi.nlm.nih.gov/pubmed/23958032 http://dx.doi.org/10.1186/1743-0003-10-98 |
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author | Buckley, John G De Asha, Alan R Johnson, Louise Beggs, Clive B |
author_facet | Buckley, John G De Asha, Alan R Johnson, Louise Beggs, Clive B |
author_sort | Buckley, John G |
collection | PubMed |
description | BACKGROUND: In this paper we use multivariate statistical techniques to gain insights into how adaptive gait involving obstacle crossing is regulated in lower-limb amputees compared to able-bodied controls, with the aim of identifying underlying characteristics that differ between the two groups and consequently highlighting gait deficits in the amputees. METHODS: Eight unilateral trans-tibial amputees and twelve able-bodied controls completed adaptive gait trials involving negotiating various height obstacles; with amputees leading with their prosthetic limb. Spatiotemporal variables that are regularly used to quantify how gait is adapted when crossing obstacles were determined and subsequently analysed using multivariate statistical techniques. RESULTS AND DISCUSSION: There were fundamental differences in the adaptive gait between the two groups. Compared to controls, amputees had a reduced approach velocity, reduced foot placement distance before and after the obstacle and reduced foot clearance over it, and reduced lead-limb knee flexion during the step following crossing. Logistic regression analysis highlighted the variables that best distinguished between the gait of the two groups and multiple regression analysis (with approach velocity as a controlling factor) helped identify what gait adaptations were driving the differences seen in these variables. Getting closer to the obstacle before crossing it appeared to be a strategy to ensure the heel of the lead-limb foot passed over the obstacle prior to the foot being lowered to the ground. Despite adopting such a heel clearance strategy, the lead-foot was positioned closer to the obstacle following crossing, which was likely a result of a desire to attain a limb/foot angle and orientation at instant of landing that minimised loads on the residuum (as evidenced by the reduced lead-limb knee flexion during the step following crossing). These changes in foot placement meant the foot was in a different part of swing at point of crossing and this explains why foot clearance was considerably reduced in amputees. CONCLUSIONS: These results highlight that trans-tibial amputees use quite different gait adaptations to cross obstacles compared with controls (at least when leading with their prosthetic limb), indicating they are governed by different constraints; seemingly related to how they land on/load their prosthesis after crossing the obstacle. |
format | Online Article Text |
id | pubmed-3751839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-37518392013-08-24 Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses Buckley, John G De Asha, Alan R Johnson, Louise Beggs, Clive B J Neuroeng Rehabil Research BACKGROUND: In this paper we use multivariate statistical techniques to gain insights into how adaptive gait involving obstacle crossing is regulated in lower-limb amputees compared to able-bodied controls, with the aim of identifying underlying characteristics that differ between the two groups and consequently highlighting gait deficits in the amputees. METHODS: Eight unilateral trans-tibial amputees and twelve able-bodied controls completed adaptive gait trials involving negotiating various height obstacles; with amputees leading with their prosthetic limb. Spatiotemporal variables that are regularly used to quantify how gait is adapted when crossing obstacles were determined and subsequently analysed using multivariate statistical techniques. RESULTS AND DISCUSSION: There were fundamental differences in the adaptive gait between the two groups. Compared to controls, amputees had a reduced approach velocity, reduced foot placement distance before and after the obstacle and reduced foot clearance over it, and reduced lead-limb knee flexion during the step following crossing. Logistic regression analysis highlighted the variables that best distinguished between the gait of the two groups and multiple regression analysis (with approach velocity as a controlling factor) helped identify what gait adaptations were driving the differences seen in these variables. Getting closer to the obstacle before crossing it appeared to be a strategy to ensure the heel of the lead-limb foot passed over the obstacle prior to the foot being lowered to the ground. Despite adopting such a heel clearance strategy, the lead-foot was positioned closer to the obstacle following crossing, which was likely a result of a desire to attain a limb/foot angle and orientation at instant of landing that minimised loads on the residuum (as evidenced by the reduced lead-limb knee flexion during the step following crossing). These changes in foot placement meant the foot was in a different part of swing at point of crossing and this explains why foot clearance was considerably reduced in amputees. CONCLUSIONS: These results highlight that trans-tibial amputees use quite different gait adaptations to cross obstacles compared with controls (at least when leading with their prosthetic limb), indicating they are governed by different constraints; seemingly related to how they land on/load their prosthesis after crossing the obstacle. BioMed Central 2013-08-16 /pmc/articles/PMC3751839/ /pubmed/23958032 http://dx.doi.org/10.1186/1743-0003-10-98 Text en Copyright © 2013 Buckley et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Buckley, John G De Asha, Alan R Johnson, Louise Beggs, Clive B Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title | Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title_full | Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title_fullStr | Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title_full_unstemmed | Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title_short | Understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
title_sort | understanding adaptive gait in lower-limb amputees: insights from multivariate analyses |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751839/ https://www.ncbi.nlm.nih.gov/pubmed/23958032 http://dx.doi.org/10.1186/1743-0003-10-98 |
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