Influence of physical capacities of males with transtibial amputation on gait adjustments on sloped surfaces

The aim of the study was to investigate how kinematic and kinetic adjustments between level and slope locomotion of persons with transtibial amputation are related to their individual muscular and functional capacities. A quantified gait analysis was conducted on flat and slope surfaces for seven patients with transtibial amputation and a control group of eight subjects to obtain biomechanical parameters. In addition, maximal isometric muscular strength (knee and hip extensors) and functional scores were measured. The results of this study showed that most of the persons with transtibial amputation could adapt to ramp ascent either by increasing ankle, knee, and hip flexion angles of the residual limb and/or by recruiting their hip extensors to guarantee enough hip extension power during early stance. Besides, 6-minute walk test score was shown to be a good predictor of adaptation capacities to slope ascent. In ramp descent, the increase of knee flexion moment was correlated with knee extensor strength and residual-limb length. However, no correlation was observed with functional parameters. Results show that the walking strategy adopted by persons with transtibial amputation to negotiate ramp locomotion mainly depends on their muscular capacities. Therefore, muscular strengthening should be a priority during rehabilitation.This material was based on work supported by the French National Research Agency (grant ANR-2010-TECS-020)