The prevalence of gait deviations in individuals with transtibial amputation

Individuals with a transtibial amputation (TTA) are at increased risk for developing secondary musculoskeletal disorders as a result of multiple gait deviations. These deviations are primarily characterized using group mean comparisons, which do not establish if deviations are prevalent, of large magnitude, or both. In contrast, use of normative reference ranges and prevalence specifically identifies the percentage of individuals outside of a predefined acceptable range. The purpose of this study was to identify and characterize gait deviations in service members with unilateral TTA using group mean comparisons and normative reference ranges (able-bodied mean ± 2 SD). Temporal spatial, kinematic, and kinetic data were collected during biomechanical gait assessments of 40 able-bodied males and 16 males with a TTA. Highly prevalent and statistically significant deviations were observed at the ankle and knee of the prosthetic limb and hip of the intact limb in the TTA group. Approximately 20% of measures that were significantly different between groups demonstrated 0% deviation prevalence. Deviations in the prosthetic limb were in agreement with literature, although most intact limb deviations were not. Further study is needed to determine the exact etiology of these deviations, and their association with the development of secondary musculoskeletal conditions.