TY - JOUR
T1 - Overall Greater Demands on the Musculoskeletal System at Multiple Walking Speeds in Service Members With Lower Limb Loss
AU - Wasser, Joseph G.
AU - Acasio, Julian C.
AU - Miller, Ross H.
AU - Hendershot, Brad D.
N1 - Funding Information:
This work was supported, in part, by the Center for Rehabilitation Sciences Research, of the Uniformed Services University of the Health Sciences (award HU0001-15-2-003; Principal Investigator/Director: Paul F. Pasquina), and the Extremity Trauma and Amputation Center of Excellence (Public Law 110-417; National Defense Authorization Act 2009, section 723). The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policies of the Uniformed Services University of the Health Sciences, Henry M. Jackson Foundation for the Advancement of Military Medicine, the US Departments of the Army, Navy, Air Force, Defense, nor the US Government. The identification of specific products or instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the authors, Department of Defense, or any component agency. The authors also wish to acknowledge Dr Alison Pruziner, PT, DPT, ATC and Dr Rebecca Krupenevich, PhD, for their contributions to idea formulation, project management, and data collection for the primary project from which this data was generated.
Funding Information:
This work was supported, in part, by the Center for Rehabilitation Sciences Research, of the Uniformed Services University of the Health Sciences (award HU0001-15-2-003; Principal Investigator/Director: Paul F. Pas-quina), and the Extremity Trauma and Amputation Center of Excellence (Public Law 110-417; National Defense Authorization Act 2009, section 723). The views expressed in this manuscript are those of the authors and do not necessarily reflect the official policies of the Uniformed Services University of the Health Sciences, Henry M. Jackson Foundation for the Advancement of Military Medicine, the US Departments of the Army, Navy, Air Force, Defense, nor the US Government. The identification of specific products or instrumentation is considered an integral part of the scientific endeavor and does not constitute endorsement or implied endorsement on the part of the authors, Department of Defense, or any component agency. The authors also wish to acknowledge Dr Alison Pruziner, PT, DPT, ATC and Dr Rebecca Krupenevich, PhD, for their contributions to idea formulation, project management, and data collection for the primary project from which this data was generated.
Publisher Copyright:
© 2021 Human Kinetics, Inc.
PY - 2021
Y1 - 2021
N2 - Individuals with lower limb loss often walk with altered/asymmetric movement mechanics, postulated as a catalyst for development of low back and knee pain. Here, the authors simultaneously investigated trunk-pelvic movement patterns and lower limb joint kinematics and kinetics among 38 males with traumatic, unilateral lower limb loss (23 transtibial and 15 transfemoral), and 15 males without limb loss, at a self-selected and 2 standardized (1.0 and 1.6 m/s) speeds. Individuals with versus without lower limb loss walked with greater trunk range of motion in the frontal and transverse planes at all speeds (despite ∼10% slower self-selected speeds). At all speeds, individuals with versus without limb loss exhibited +29% larger medial ground reaction forces, and at 1.6 m/s also exhibited +50% to 110% larger vertical hip power generation, +27% to 80% larger vertical hip power absorption, and +21% to 90% larger medial-lateral hip power absorption. Moreover, pervasive biomechanical differences between transtibial versus transfemoral limb loss identify amputation-level movement strategies. Overall, greater demands on the musculoskeletal system across walking speeds, particularly at the hip, knee, and low back, highlight potential risk factors for the development/recurrence of prevalent secondary musculoskeletal conditions (eg, joint degeneration and pain) following limb loss.
AB - Individuals with lower limb loss often walk with altered/asymmetric movement mechanics, postulated as a catalyst for development of low back and knee pain. Here, the authors simultaneously investigated trunk-pelvic movement patterns and lower limb joint kinematics and kinetics among 38 males with traumatic, unilateral lower limb loss (23 transtibial and 15 transfemoral), and 15 males without limb loss, at a self-selected and 2 standardized (1.0 and 1.6 m/s) speeds. Individuals with versus without lower limb loss walked with greater trunk range of motion in the frontal and transverse planes at all speeds (despite ∼10% slower self-selected speeds). At all speeds, individuals with versus without limb loss exhibited +29% larger medial ground reaction forces, and at 1.6 m/s also exhibited +50% to 110% larger vertical hip power generation, +27% to 80% larger vertical hip power absorption, and +21% to 90% larger medial-lateral hip power absorption. Moreover, pervasive biomechanical differences between transtibial versus transfemoral limb loss identify amputation-level movement strategies. Overall, greater demands on the musculoskeletal system across walking speeds, particularly at the hip, knee, and low back, highlight potential risk factors for the development/recurrence of prevalent secondary musculoskeletal conditions (eg, joint degeneration and pain) following limb loss.
KW - amputation
KW - chronic injury
KW - gait kinematics
KW - knee osteoarthritis
KW - low back pain
UR - http://www.scopus.com/inward/record.url?scp=85120977992&partnerID=8YFLogxK
U2 - 10.1123/jab.2020-0287
DO - 10.1123/jab.2020-0287
M3 - Article
C2 - 34689127
AN - SCOPUS:85120977992
SN - 1065-8483
VL - 37
SP - 522
EP - 530
JO - Journal of Applied Biomechanics
JF - Journal of Applied Biomechanics
IS - 6
ER -