Successful prosthetic rehabilitation and gait analysis of individual with bilateral transtibial amputation: A case study with comparison to able-bodied gait

Abstract

Background: Intensive rehabilitation of individuals with bilateral lower limb loss poses a great challenge to both rehabilitation team and amputees themselves due to unavailability of a sound leg to provide stability in standing and gait. Although gait characteristics of individuals with unilateral transtibial amputations are well documented in the literature, very less is known about those with bilateral limb loss. Aim: To examine the gait characteristics of an individual with bilateral transtibial amputation (BTA) and its comparison with an able-bodied (AB). This study also provides a real-life presentation of successful prosthetic rehabilitation. Case content and methodology: Temporal–spatial, kinematic and kinetic gait parameters were analysed for a 45-year-old male individual with traumatic BTA using prosthesis in a motion analysis laboratory setting with force platform (BTS P-6000) and cameras with reflective markers (BTS SMART-DX6000). Findings and conclusion: Variances in many temporal–spatial, kinematic and kinetic parameters were observed. The findings of temporal–spatial parameters revealed that the individual with BTA walked with slower speed, lower cadence, shorter step lengths and wider step width compared to that of AB. Ankle dorsiflexion, stance knee flexion and swing hip hiking were reduced in an individual with BTA compared to AB. In kinetics, he demonstrated low peak ankle muscle power, increased muscle power amplitudes and phase duration at the hip and knee joints compared to AB individual. The combination of an intensive prosthetic rehabilitation led to completely independent and remarkable degree of functional ambulation.