Gait asymmetry is associated with performance-based physical function among adults with lower-limb amputation

ABSTRACT

Background

Adults with lower-limb amputation walk with an asymmetrical gait and exhibit poor functional outcomes, which may negatively impact quality-of-life.

Objective

To evaluate associations between gait asymmetry and performance-based physical function among adults with lower-limb amputation.

Methods

A cross-sectional study involving 38 adults with a unilateral transtibial (N = 24; 62.5 ± 10.5 years) or transfemoral amputation (N = 14; 59.9 ± 9.5 years) was conducted. Following gait analysis (capturing step length and stance time asymmetry at self-selected (SSWS) and fast walking speeds (FWS)), participants completed performance-based measures (i.e. Timed Up and Go (TUG), the 10-Meter Walk Test (10mwt), and the 6-Minute Walk Test (6MWT)).

Results

Step length and stance time asymmetry (at SSWS and FWS) were significantly correlated with each performance-based measure (p < .001 to p = .035). Overall, models with gait measures obtained at SSWS explained 40.1%, 46.8% and 40.1% of the variance in TUG-time (p = .022), 10mwt-speed (p = .003) and 6MWT-distance (p = .010), respectively. Models with gait measures obtained at FWS explained 70.0%, 59.8% and 51.8% of the variance in TUG-time (p < .001), 10mwt-speed (p < .001), and 6MWT-distance (p < .001), respectively.

Conclusions

Increases in step length or stance time asymmetry are associated with increased TUG-time, slower 10mwt-speed, and reduced 6MWT-distance. Findings suggest gait asymmetry may be a factor in poor functional outcomes following lower-limb amputation.

KEYWORDS:

• Amputation
• outcome measures
• prosthesis
• rehabilitation
• walking speed

Acknowledgments

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number R03HD088668. Data collections and manuscript preparation by Dr. Beisheim were supported by the National Institute of Health (award number: T32HD007490) and Promotion of Doctoral Studies I and II scholarships from the Foundation for Physical Therapy Research. Dr. Seth is supported by a Postdoctoral Researcher Fund provided by Independence Prosthetics-Orthotics, Inc.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health [R03HD088668]; Foundation for Physical Therapy Research [Promotion of Doctoral Studies I & II scholarships]; National Institutes of Health [T32HD007490]; Independence Prosthetics-Orthotics, Inc [Postdoctoral Researcher Fund].