1. Antonia Nepomuceno1,2, Matthew Major2,3, Rebecca Stine3, Steven Gard2,3
1University of Illinois at Urbana-Champaign, Urbana, IL, 2Norwestern University Prosthetics-Orthotics Center, Chicago, IL, 3Jesse Brown VA Medical Center, Chicago, IL
Effect of Ankle Immobilization on Able-Bodied Gait to Model Bilateral Transtibial Amputee Gait
References
[1] Perry J. Gait Analysis: Normal and Pathological
Function, 1992.
[2] Su P. F. J Rehab Res Dev, 44, 491-501, 2007.
[3] Major M. J. Gait Posture 38, 858-863, 2013.
[4] Kadaba M. P. J Orthop Res, 8, 383-92, 1990.
Conclusions
• Restricted active ankle motion generates
gait compensatory mechanisms observed in
BTA gait.
• Increased hip power generation may
compensate for reduced ankle power
generation during pre-swing.
• Increased trunk motion may help facilitate
forward ambulation.
Method
Subjects: Nine AB individuals (27±3 yrs,
1.75±0.10 m, 76±17 kg) were included in
this study. Ten BTA prosthesis users
(50±18 yrs, 1.73±0.08 m, 82±16 kg) from a
previous study [3] were included for
comparison.
Apparatus: Motion data were collected with
a digital motion capture system (Motion
Analysis Corporation (MAC), Santa Rosa,
CA) and Helen Hayes marker set [4]. Ground
reaction force data were collected with
force plates (AMTI, Watertown, MA)
embedded in a 10 m walkway.
Procedure: Subjects walked at normal and
fast self-selected speeds, without and with
casts, respectively. The bilateral casts
(Delta-Lite Fiberglass, BSN Medical Ltd.,
Brierfield, UK), were fitted from below the
knee joint to the toes with the ankle joints in
a neutral position.
Data Analysis: OrthoTrak software (MAC)
was used to estimate lower extremity joint
kinematics and kinetics.
Introduction
• The able-bodied (AB) foot-ankle complex
facilitates advancement of the stance limb
through roll-over and power generation [1]
• The ankle’s function is altered or diminished
for bilateral transibial amputees (BTAs) when
using passive foot-ankle prostheses [2]
• BTAs utilize compensatory mechanisms to
maintain forward ambulation [2,3]
Purpose:
Investigate the effects of ankle
immobilization on the kinetics and
kinematics of AB gait and compare these
dynamics to BTA gait.
Results
The normal and fast self-selected speed data for AB and BTA subjects, respectively, were used
for speed-matched data comparison.
Results Continued
In the casted condition:
• Ankle range of motion greatly reduced
• Trunk range of motion increased in all
directions
• Ankle power generation decreased during
pre-swing, hip power generation increased
• Abnormal walking trends tend to mimic the
BTA data
Without
Casts
With
Casts
Ankle ROM (°) 31.1 ± 3.3 8.4 ± 3.0
Trunk Lateral ROM (°) 3.3 ± 1.3 5.8 ± 2.8
Trunk Forward Lean (°) -2.0 ± 3.7 1.5 ± 4.1
Trunk Rotation ROM (°) 10.6 ± 2.4 15.6 ± 4.7
Max Ankle Power (Watt/kg) 2.5 ± .34 .70 ± .53
2nd Peak Hip Power (Watt/kg) .97 ± .18 1.3 ± .28
— No Cast
∙ ∙ ∙ With Cast
− − BTA Data [3]