Pelvic and scapular girdles’ movements during walking on level ground in unilateral transtibial amputees

Abstract

Objective Modification of the musculoskeletal system of lower limb amputees, as well as the inability of the prosthesis to compensate the loss of the elements necessary for “normal” walking, could disrupt postural control and thus specifically characterize the gait of amputees. Most studies focused on kinematics lower limbs parameters to assess transtibial amputees (TTA) gait. However, other studies have shown the essential role of shoulder movement in the human gait. The modification of this counter-rotation movement in the horizontal plane is characteristic of specific pathologies. The aim was to enhance the compensation strategies of TTA during walking on level ground, by assessing the kinematic of pelvic and scapular girdles’ movements in the sagittal and horizontal planes. Material/patients and methods Twenty able-bodies individuals (AB) and 19 TTA walked, with their own prosthetic devices and shoes, at their self-selected speed on level ground in a motion capture laboratory. Distance between the right and the left acromions and distance between the right and the left anteriosuperior iliac spines in the sagittal plane and the angle of counter-rotation between the pelvic and the scapular girdles in the horizontal plane were measured manually. These values were assessed considering gait cycle, and compared between groups. Results In the sagittal plane, the shoulder movements were significantly greater in TTA compared to AB (P = 0.03). Moreover, an anticipation of the maximum forward shoulder displacement in TTA was observed at 40% of gait cycle, contrary to AB, in whom it was observed at 53% of gait cycle. However, the amplitude of counter-rotation between shoulder and pelvis and the moment when counter-rotation occurred in gait cycle were not significantly different between groups in the horizontal plane. Two counter-rotations of scapular and pelvic girdles occurred at the beginning and in the middle of the gait cycle. Discussion, conclusion The kinematic analysis of the scapular and pelvic girdles movements during level walking showed a specific characterization of the gait of TTA related to their disability due to the loss of residual limb muscles. The displacement of scapular girdle in the sagittal plane is an important compensatory factor for transtibial amputees.