Assessment of Unilateral Transtibial Amputee Gait Deviations Through Instrumented Gait Analysis: A Review

Abstract The detection of gait abnormalities is a topic that has been of great interest in recent years. However, most of the reported literature has focused on healthy subjects or subjects with various pathologies. Specifically, the detection of abnormal gait patterns in lower limb amputees is a field that has not yet been widely explored. To develop a system that is capable of detecting these gait abnormalities, each of these abnormal patterns needs to be characterized. It is necessary to determine which are the most relevant features in each of these patterns.To the author’s knowledge, few abnormal gait patterns of lower limb amputees have been characterized and those reported in the literature focus on gait abnormalities in people with transfemoral amputation and not with transtibial amputation. For this reason, the objective of this article is to review the existing literature on gait deviations that were measured using instrumented gait analysis methods in order to establish which variables/features best characterize or represent the different gait patterns of transtibial amputees. A search in biomedical databases was carried out, after reviewing the literature and removing articles that did not meet the inclusion criteria, 37 articles remained. Variables that authors found of significance relative to specific gait patterns were extracted. These variables can be kinematic, kinetic, spatio-temporal, or physiological variables. In the literature found, the experiments were performed on flat surfaces, stairs, and destabilizing surfaces. Flat surfaces were the most prevalent surface used in literature. Multiple authors reported that the energy expenditure of transtibial amputees was the same as un-amputated controls. Transtibial amputee gait should be considered asymmetrical, many authors have found that persons with kinematic variables in acceptable ranges show compensatory patterns in kinematic or physiological variables. This behavior shows that to have a normal ambulation amputees generate asymmetrical loads which can lead to osteoarthritis or lower back pain. The reviewed literature provides characteristics about gait deviations of healthy transtibial amputees in different walking conditions. Additional research exploring other walking conditions or gait patterns of individuals without rehabilitation is required.