ATLANTA — Transfemoral amputees with low back pain move differently than those without, according to researchers from Northwestern University Prosthetics and Orthotics Center.
In the ongoing study, Azucena G. Rodriguez, PhD, and Stefania Fatone, PhD, BPO (Hons) determined whether there are differences in spine kinematics during walking in unilateral transfemoral amputees with and without low back pain. The study was a Thranhardt Lecture finalist at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium here.
Current data includes results from 7 non-obese amputees with pain and 8 amputees without pain. Participants have been amputees for an average of 20 years, with a medium length residual limb.
The participants with low back pain experienced pain within 30 days of study inclusion. They assessed their pain with a visual analog scale, with 0 being no pain and 10 being extreme pain. Participants were assessed for a minimum of five trials at a comfortable walking speed in a motion analysis laboratory.
Results showed there was no difference in socket and comfort score between the pain and no pain groups.
Eleven participants exhibited vaulting on the sound side. Fourteen participants experienced a lack of prosthetic side stance phase knee flexion, while 10 participants experienced hip hiking on the prosthetic leg during swing phase.
The researchers suggested that the majority of motion occurs as the prosthetic limb transitions from stance to swing and that all of the transfemoral amputees appeared to use sagittal plane pelvic motion to facilitate transition of the prosthetic limb into swing phase.
“When we looked at pelvic motion, the most consistent pattern we observed was in the sagittal plane,” according to Fatone.
Although all participants appeared to use sagittal plane pelvic motion to facilitate transition of the prosthesis into swing page, the motion was more distinct, less variable, and of smaller range in participants without back pain.
“The group without pain seemed to have lower range of motion in all segments in the sagittal and coronal planes,” she said.
Results thus far demonstrate that step length, width and walking speed do not differ between the groups, Fatone said.
Rodriguez A, Stine R, Gard S, Fatone S. Spinal motion during walking in persons with transfemoral amputation with and without low back pain. Presented at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. March 21-24. Atlanta.