Compensatory Gait Strategies in Persons with Transfemoral Amputations Walking with a Locked Prosthetic Knee Joint Compared with an Unlocked Knee Joint: A Crossover Trial

Abstract

Introduction: Individuals with transfemoral amputation walking with a locked prosthetic knee joint (LPKJ) have compromised degree of freedom in leg movement compared with walking with an unlocked prosthetic knee joint (UPKJ), thus presenting a risk for compensatory gait strategies, with risk of lower back pain. The objective was to compare gait strategies in individuals with transfemoral amputation walking with an LPKJ and a UPKJ. Materials and Methods: This was a crossover trial. Nine individuals with transfemoral amputation habitually walking with a UPKJ completed an intervention of 1 to 2 weeks of walking with a UPKJ followed by 1 to 2 weeks of walking with an LPKJ. Gait strategies were analyzed after each intervention using three-dimensional gait analysis. The outcome was pelvic and lumbar spinal movement from terminal stance to initial swing in the sagittal and transversal plane. Results: The maximum anterior tilt of the pelvis in the sagittal plane and the pelvic rotation shifted from preswing to initial swing in the gait cycle when walking with an LPKJ compared with the UPKJ. Conclusions: A compensatory gait strategy was observed among individuals with transfemoral amputation walking with an LPKJ compared with a UPKJ. Studies should investigate the incidence of low back pain in individuals with transfemoral amputation walking with LPKJ compared with those walking with UPKJ.