Investigation of symmetry in sagittal knee kinematics during running in transtibial amputees

Abstract

Background

People with transtibial amputation often suffer musculoskeletal deformities in the form of knee osteoarthritis or osteophytosis due to asymmetric movement patterns and often complain of associated symptoms.

Objective:

This study aimed to evaluate the sagittal kinematics of the intact and residual knee in the use of Running-Specific Prostheses (RSP), which are increasing in popularity and use among amputees.

Methods:

Participants were video recorded in the sagittal plane to make measurements using the software's virtual goniometer. The recordings were taken under the following two conditions: 1) walking with Daily-Use Prosthesis (DUP), 2) running with RSP. The peak flexion during swing phase and the initial flexion during stance phase were recorded as angle.

Results:

Fourteen participants were recruited the study (aged 33.43 ± 1.46 years). The difference in peak knee flexion between the amputated and intact limbs was statistically significant (walking p < 0.001, running p = 0.02). The difference in initial knee flexion in the amputated and intact limbs was statistically significant walking (p = 0.011), but not during running (p = 0.203). According to Symmetry Index, peak knee flexion during running was in the ‘good symmetry’ interval, while peak knee flexion during walking and initial knee flexion during running were in the ‘moderate symmetry’ interval. The initial knee flexion during walking was in the ‘asymmetric’ interval.

Conclusions:

Running improves symmetry scores including the sagittal position of the knee joint. This suggests that, running at recreational level can be used as a strategy for the stimulation of symmetric movement patterns.