Variability in trunk and pelvic movement of transfemoral amputees using a C-leg system compared to healthy controls.

OBJECTIVE:Gait variability is a measure of gait disturbance, and therefore constitutes a useful parameter for gait assessment as well as planning of therapeutic and medical interventions. To date, variability during walking has not been adequately analyzed in amputees. The aim of this examination was to evaluate trunk and pelvic movement variability in transfemoral amputees. The effect of different types of walking surfaces on variability in trunk and pelvic movement was also studied. METHOD:This prospective clinical examination compares 20 transfemoral amputees (17 ♂, 42 ± 16 years; 3 ♀, 48 ± 3 years) with a group of 20 age and mass matched healthy controls regarding the extent of variability in trunk and pelvic movement. Kinematic data of trunk and pelvic movement during walking on level, uneven ground and slope was captured by eight infrared cameras (Vicon Nexus ™, Oxford, UK). Variability in trunk and pelvic movement was analyzed. Univariate ANCOVA and ANOVA with repeated measures and post hoc tests were used for statistical comparison. Fall history was retrospectively collected from medical history to assess the association between falls and variability in trunk and pelvic movement. RESULTS:Trunk and pelvic movement variability in amputees was significantly higher during walking on uneven ground and slope compared to healthy controls (p ≤ 0.05). Variability in trunk and pelvic movement was increased during walking on uneven ground and slope compared to even ground for both groups (p ≤ 0.05). CONCLUSION:Amputees showed increased trunk and pelvic movement variability during walking on uneven ground and slope, indicating an affected gait pattern in comparison to healthy controls. Therefore, trunk and pelvic movement variability could be a potential marker for gait quality with diagnostic implications.