Effects of inclined surfaces on gait variability and stability in unilateral lower limb amputees
- 21 Downloads
This study aims to analyze gait variability and stability of individuals with amputation walking on upward (8%), horizontal (0%), and downward (− 8%) inclines, by using linear and nonlinear descriptors. Trunk linear variability and gait spatiotemporal parameters were evaluated. Nonlinear variability (local dynamic stability-LDS), was estimated by the maximum Lyapunov exponent (λ) computed from a trunk marker velocity. The gait descriptors were compared among three distinct groups (N participants): unilateral transtibial amputees (TTA, N = 12); unilateral transfemoral amputees (TFA, N = 13); control group (CT, N = 15). For step width and support phase, the effect of inclination was greater for TFA group, especially in the DOWN condition. Linear variability was higher for amputees (TFA and TTA) especially in the UP condition in the medial-lateral and anterior-posterior directions. TTA and TFA groups presented greater λ values than CT group in medial-lateral direction indicating decreased LDS, but TFA group presented smaller λ values than TTA and CT groups in the V direction. Our findings showed that inclination introduced significant changes in the estimated parameters for all groups, with greater changes for amputee groups. Furthermore, the level of amputation directly affects the analyzed gait parameters being the TFA group the one which presents greater changes.
KeywordsGait variability Inclined walking Maximum Lyapunov exponent Nonlinear analysis
The authors are thankful to governmental agencies CNPq, CAPES, FAPEG, and FAPEMIG for supporting this study. Adriano O. Andrade and Marcus Fraga Vieira are a Fellow of CNPq, Brazil (304818/2018-6 and 306205/2017-3, respectively).
- 8.Whitmore MW, Hargrove LJ, Perreault EJ. (2015) Lower-limb muscle activity when walking on different slippery surfaces. 2015 7th Int IEEE/EMBS Conf Neural Eng, IEEE, p. 783–6. https://doi.org/10.1109/NER.2015.7146740.
- 9.Liu M, Bohlen P, Huang HH. (2016) Effect of environmental factors on level of trip disturbance: a simulation study. 2016 38th Annu Int Conf IEEE Eng Med Biol Soc, IEEE, p. 5038–41. https://doi.org/10.1109/EMBC.2016.7591859.
- 10.Sheehan RC, Rabago CA, Rylander JH, Dingwell JB, Wilken JM (2016) Use of perturbation-based gait training in a virtual environment to address mediolateral instability in an individual with unilateral transfemoral amputation. Phys Ther 96:1896–1904. https://doi.org/10.2522/ptj.20150566 CrossRefGoogle Scholar
- 11.Chen J-L, Gu D-Y. (2013) Local dynamic stability of lower extremity joints in lower limb amputees during slope walking. 35th Annu Int Conf IEEE Eng Med Biol Soc, IEEE, p. 7241–4. https://doi.org/10.1109/EMBC.2013.6611229.
- 13.Bruijn SM, Meijer OG, Beek PJ, Van Dieen JH (2013) Assessing the stability of human locomotion: a review of current measures, 20120999. J R Soc Interface 10. https://doi.org/10.1098/rsif.2012.0999
- 14.Torburn L, Powers CM, Guiterrez R, Perry J (1995) Energy expenditure during ambulation in dysvascular and traumatic below-knee amputees: a comparison of five prosthetic feet. J Rehabil Res Dev 32:111–119Google Scholar
- 21.Strogatz SH (2014) Nonlinear dynamics and chaos: with applications to physics, biology, chemistry, and engineering, 2nd edn. CRC Press, Boca RatonGoogle Scholar
- 35.Robertson DGE, Caldwell GE, Hamill J, Kamen G, Whittlessey SN (2014) Research methods in biomechanics, 2nd edn. Human Kinetics, ChampaignGoogle Scholar