Whole body movement strategies during sit-to-stand and stair ascent in individuals with a lower limb amputation: A systematic review. (December 2022)

• Record Type: Journal Article
• Authors: Miramand, Ludovic; Moisan, Gabriel; Richard, Vincent; McFadyen, Bradford J.; Turcot, Katia
• Is Part Of: Clinical biomechanics. Volume 100(2022)
• Publication Date: 2022-12
• Subjects: Amputation -- Kinetics -- Kinematics -- Review -- Sit-to-stand -- Stair gait; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2022.105811
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Individuals with a lower limb amputation use compensatory strategies during essential tasks such as sit-to-stand and stair ascent leading to secondary physical conditions. The ensuing biomechanical parameters outlining the motion strategies they put in place need to be identified and described. Methods: We searched three databases (Embase, IEEE Xplore and PubMed) for articles on the spatiotemporal, the kinematics and the kinetics that compared the amputated, the intact lower limbs, or the trunk of individuals with a unilateral transtibial or transfemoral amputation with the limbs of a control group. Findings: We found twenty articles. During sit-to-stand, individuals with a lower limb amputation increased the trunk inclination angle toward the intact lower limb, explaining higher ground reaction forces and peak knee sagittal power generation. During stair ascent, individuals with a lower limb amputation increased the stance phase duration on the intact lower limb. Moreover, individuals with a lower limb amputation increased both lower limbs hip extension moment and power, and the amputated lower limb knee extension moment. In both tasks, the individuals with a transfemoral amputation presented larger differences than those with transtibial compared to the control group. Interpretation: Both lower limbs intact joint moment and power were increased to compensate for the prosthesis passive joint and to ensure stability. Stair gait studies mainly focused on the lower limbs' biomechanical changes in the sagittal plane, while sit-to-stand studies focused on asymmetries without comparing the lower limbs independently. Better methodological descriptions are essential to enhance the external validity of previous results. Highlights: Stair gait and sit-to-stand are crucial for individuals with lower limb amputation. Trunk and lower limbs need to be investigated during both tasks. This review identified the most relevant parameters underlying movement strategies. Moment and power show that residual joints compensate for the prosthetic joint. Trunk and lower limb need to be more investigated during both tasks.