Three-dimensional motions of trunk and pelvis during transfemoral amputee gait.

OBJECTIVES To identify characteristics of upper-body kinematics and torque transmission to the ground during locomotion in a group of patients with transfemoral amputation as compared with a group of asymptomatic subjects; and to investigate the influence of walking velocity and residual limb length on several characteristics of upper-body motion. DESIGN Three-dimensional gait analysis with an optoelectronic device. SETTING Gait laboratory. PARTICIPANTS Twenty-seven patients with transfemoral amputation and a control group of 33 nondisabled subjects. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Three-dimensional kinematics of the pelvis and the thorax and ground reaction force for amputees and control subjects. RESULTS For subjects with transfemoral amputation, it was observed that upper-body angular ranges of motion (ROMs) increased globally as walking velocity decreased. For these subjects, specific patterns of pelvic rotation and torque transmission by the lower limbs around the vertical axis were found. The counter-rotation between the pelvic and scapular girdles was reduced. This reduction proved to be linked with the decrease of walking velocity. Walking velocity also affected all the parameters describing the motion of upper body. Pelvic ROM increased with the length of the limb decreasing. CONCLUSIONS The huge differences found between subjects with and without amputation suggest that the motion of the upper body must be considered to enhance gait.