Gait analysis in prosthetics: Opinions, ideas and conclusions

A review was performed of the literature of the last eleven years (1990-2000) with the topic: "clinical use of instrumented gait analysis in patients wearing a prosthesis of the lower limb". To this end a literature search was performed in Embase, Medline and Recal. Forty-five (45) articles were identified for study from which 34 were reviewed. The reviews were divided into five subtopics: 1) adaptive strategies in gait (12 studies); 2) the influence of different parts of the prosthesis on gait (12 studies); 3) pressure measurements in the socket in gait studies (4 studies); 4) the influence of the mass of the prostheses on gait (5 studies); 5) energy considerations in gait (2 studies). A considerable part of the studies concerned the adaptive strategies of the amputee in walking and running and the evaluation of different prosthetic feet. All aspects and outcomes were reviewed concerning the clinical relevance. Conclusion: Instrumented gait analysis in prosthetics provides better insights and knowledge of the different adaptive mechanisms of the body in walking with a prosthesis. Most instrumented gait studies are done in a gait laboratory. This is not comparable with the patient's home or work situation. Instrumented gait studies assess only the impairments. Assessment of disabilities and the subjective opinion of the patients' remain necessary. It is the authors' opinion that the future of instrumented gait analysis in prosthetics is mainly for scientific research in which one should critically consider the number of patients to be studied, to show some clinically relevant differences. It is also important to test new prosthetic components, to investigate whether they improve the gait of the amputee wearing the prosthesis