Spinal and Pelvic Kinematics During Gait in People with Lower-Limb Amputation, with and without Low Back Pain: An Exploratory Study

Abstract

ABSTRACT Introduction Despite the high prevalence of chronic low back pain (LBP) in people with lower-limb amputation, it is not clear whether there are differences in spinal and pelvic motion in individuals with and without LBP. This exploratory study aimed to describe the spinal and pelvic kinematics during gait in people with transfemoral amputation (TFA) and transtibial amputation (TTA), with and without LBP. Methods Eighteen participants with traumatic amputation (6 TFA, 12 TTA) were grouped according to their amputation level and presence (or absence) of LBP. Three-dimensional thoracic, lumbar, and pelvic kinematics during walking were reported to identify movement patterns that may be indicative of LBP. Results The TFA-LBP group elevated the pelvis on the intact side and minimized lumbar lateral flexion to achieve the same trunk lateral flexion angle (Trendelenburg gait) as those with TFA-No LBP. Those with TFA-LBP kept the lumbar spine rotated toward the prosthetic limb throughout the gait cycle. There were no differences in the spinal and pelvic kinematics of people with TTA-LBP and TTA-No LBP. Conclusions This study provides preliminary evidence of differences in spinal and pelvic kinematics that may be associated with LBP in people with TFA.