Thorax, pelvis and hip pattern in the frontal plane during walking in unilateral transtibial amputees: biomechanical analysis

Francisco Molina-Rueda, Isabel M Alguacil-Diego, Alicia Cuesta-Gómez, Javier Iglesias-Giménez, Andrés Martín-Vivaldi, Juan C Miangolarra-Page, Francisco Molina-Rueda, Isabel M Alguacil-Diego, Alicia Cuesta-Gómez, Javier Iglesias-Giménez, Andrés Martín-Vivaldi, Juan C Miangolarra-Page

Abstract

Background: Lower limb amputees exhibit postural control deficits during standing which can affect their walking ability.

Objectives: The primary purpose of the present study was to analyze the thorax, pelvis, and hip kinematics and the hip internal moment in the frontal plane during gait in subjects with Unilateral Transtibial Amputation (UTA).

Method: The participants included 25 people with UTA and 25 non-amputees as control subjects. Gait analysis was performed using the Vicon(r) Motion System. We analyzed the motion of the thorax, pelvis, and hip (kinematics) as well as the hip internal moment in the frontal plane.

Results: The second peak of the hip abductor moment was significantly lower on the prosthetic side than on the sound side (p=.01) and the control side (right: p=.01; left: p=.01). During middle stance, the opposite side of the pelvis was higher on the prosthetic side compared to the control side (right: p=.01: left: p=.01).

Conclusions: The joint internal moment at the hip in the frontal plane was lower on the prosthetic side than on the sound side or the control side. Thorax and pelvis kinematics were altered during the stance phase on the prosthetic side, presumably because there are mechanisms which affect postural control during walking.

Figures

Figure 1. Special lightweight surface markers in…
Figure 1. Special lightweight surface markers in volunteer with UTA.
Figure 2. Pelvis motion in the frontal…
Figure 2. Pelvis motion in the frontal plane: peak pelvis obliquity. A positive pelvis obliquity value relates to a situation in which the opposite side of the pelvis is lower. A negative pelvis obliquity value relates to a situation in which the opposite side of the pelvis is higher. Peak pelvis obliquity: (1) Peak pelvis obliquity during loading response (0-10% GC); (2) peak pelvis obliquity during midstance (10-30% GC); (3) peak pelvis obliquity during pre-swing (50-60% GC). Y axis (degrees), X axis (0-100% gait cycle [GC]).
Figure 3. (A) Hip abduction/adduction moment. Positive…
Figure 3. (A) Hip abduction/adduction moment. Positive values are abduction moment. Negative values are adduction moment. Y axis (Nm/Kg). X axis. (0-100% gait cycle). (B) Mean values of thorax motion in the frontal plane. A negative thorax obliquity angle relates to a situation in which the opposite side of the thorax is higher; a positive thorax obliquity angle relates to a situation in which the opposite side of the thorax is lower. Y axis (degrees). X axis. (0-100% gait cycle). (C) Mean values of pelvis motion in the frontal plane. A positive pelvis obliquity value relates to a situation in which the opposite side of the pelvis is lower. A negative pelvis obliquity value relates to a situation in which the opposite side of the pelvis is higher. Y axis (degrees). X axis. (0-100% gait cycle). (D) Mean values of hip motion in the frontal plane. Positive values are degrees of adducted position. Y axis (degrees). X axis. (0-100% gait cycle). Black line: Right control side; Blue line: Prosthetic side; Red line: Sound side.

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Source: PubMed

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