Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss
ABSTRACTGait asymmetry persists for most people after lower limb amputation and is associated with slower walking speeds. However, the relationship between gait asymmetry and patient-reported function remains unclear because they are not commonly assessed together. The purpose of this study was to d...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | International Biomechanics |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/23335432.2022.2142160 |
| _version_ | 1828276480549847040 |
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| author | Christopher K. Wong Emily E. Vandervort Kayla M. Moran Carly M. Adler Stanford T. Chihuri Gregory A. Youdan |
| author_facet | Christopher K. Wong Emily E. Vandervort Kayla M. Moran Carly M. Adler Stanford T. Chihuri Gregory A. Youdan |
| author_sort | Christopher K. Wong |
| collection | DOAJ |
| description | ABSTRACTGait asymmetry persists for most people after lower limb amputation and is associated with slower walking speeds. However, the relationship between gait asymmetry and patient-reported function remains unclear because they are not commonly assessed together. The purpose of this study was to determine relationships between gait asymmetries in people with lower limb loss and (1) patient-reported outcomes and (2) performance-based prosthetic functional measures. This cross-sectional analysis included nine people with unilateral limb loss aged 48.2 ± 13.1 years of mixed amputation etiology. Patient-reported outcomes included the Prosthetic Evaluation Questionnaire mobility subscale and Activities-specific Balance Confidence scale. Performance outcomes included the Berg Balance Scale and the 30-second sit-to-stand test. Walking performance measures included the 2-Minute Walk Test, during which APDM Opal sensors recorded spatiotemporal gait parameters, and daily step-counts from StepWatch4 activity monitors. The study found that the most asymmetric gait symmetry ratios (prosthetic-limb divided by intact-limb) could be attributed to prosthetic foot dorsiflexion-plantarflexion and rotation motion limitations: prosthetic-limb trailing double support (0.789 ± 0.052), toe-off (0.760 ± 0.068) and toe-out angle (0.653 ± 0.256). Single limb stance, and stance and swing phase durations were most strongly associated with balance and walking performance measures. Notably, no symmetry ratio was significantly associated with patient-reported prosthetic function (unadjusted Pearson correlation coefficients r < 0.50, P > 0.05). More gait symmetry was associated with better balance and walking performance but had no significant relationship with patient-reported function. Although achieving gait symmetry after lower limb loss is a common walking goal, symmetry was unrelated to the perception of functional mobility for people with lower limb loss. |
| first_indexed | 2024-04-13T06:57:56Z |
| format | Article |
| id | doaj.art-9ef2914fc084495898a527242baa8094 |
| institution | Directory Open Access Journal |
| issn | 2333-5432 |
| language | English |
| last_indexed | 2024-04-13T06:57:56Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Biomechanics |
| spelling | doaj.art-9ef2914fc084495898a527242baa80942022-12-22T02:57:12ZengTaylor & Francis GroupInternational Biomechanics2333-54322022-12-0191334110.1080/23335432.2022.2142160Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb lossChristopher K. Wong0Emily E. Vandervort1Kayla M. Moran2Carly M. Adler3Stanford T. Chihuri4Gregory A. Youdan5Department of Rehabilitation and Regenerative Medicine, Columbia University Irving Medical Center, New York, NY, USAProgram in Physical Therapy, Columbia University, New York, NY, USAProgram in Physical Therapy, Columbia University, New York, NY, USAProgram in Physical Therapy, Columbia University, New York, NY, USASchool of Public Health, Columbia University Irving Medical Center, New York, NY, USATeacher’s College, Columbia University, New York, NY, USAABSTRACTGait asymmetry persists for most people after lower limb amputation and is associated with slower walking speeds. However, the relationship between gait asymmetry and patient-reported function remains unclear because they are not commonly assessed together. The purpose of this study was to determine relationships between gait asymmetries in people with lower limb loss and (1) patient-reported outcomes and (2) performance-based prosthetic functional measures. This cross-sectional analysis included nine people with unilateral limb loss aged 48.2 ± 13.1 years of mixed amputation etiology. Patient-reported outcomes included the Prosthetic Evaluation Questionnaire mobility subscale and Activities-specific Balance Confidence scale. Performance outcomes included the Berg Balance Scale and the 30-second sit-to-stand test. Walking performance measures included the 2-Minute Walk Test, during which APDM Opal sensors recorded spatiotemporal gait parameters, and daily step-counts from StepWatch4 activity monitors. The study found that the most asymmetric gait symmetry ratios (prosthetic-limb divided by intact-limb) could be attributed to prosthetic foot dorsiflexion-plantarflexion and rotation motion limitations: prosthetic-limb trailing double support (0.789 ± 0.052), toe-off (0.760 ± 0.068) and toe-out angle (0.653 ± 0.256). Single limb stance, and stance and swing phase durations were most strongly associated with balance and walking performance measures. Notably, no symmetry ratio was significantly associated with patient-reported prosthetic function (unadjusted Pearson correlation coefficients r < 0.50, P > 0.05). More gait symmetry was associated with better balance and walking performance but had no significant relationship with patient-reported function. Although achieving gait symmetry after lower limb loss is a common walking goal, symmetry was unrelated to the perception of functional mobility for people with lower limb loss.https://www.tandfonline.com/doi/10.1080/23335432.2022.2142160Gaitsymmetrybalanceamputationprosthesespatient-reported outcomes |
| spellingShingle | Christopher K. Wong Emily E. Vandervort Kayla M. Moran Carly M. Adler Stanford T. Chihuri Gregory A. Youdan Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss International Biomechanics Gait symmetry balance amputation prostheses patient-reported outcomes |
| title | Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss |
| title_full | Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss |
| title_fullStr | Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss |
| title_full_unstemmed | Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss |
| title_short | Walking asymmetry and its relation to patient-reported and performance-based outcome measures in individuals with unilateral lower limb loss |
| title_sort | walking asymmetry and its relation to patient reported and performance based outcome measures in individuals with unilateral lower limb loss |
| topic | Gait symmetry balance amputation prostheses patient-reported outcomes |
| url | https://www.tandfonline.com/doi/10.1080/23335432.2022.2142160 |
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