Planar covariation of elevation angles in prosthetic gait

Abstract

In order to achieve efficacious walking, transfemoral amputees must adapt coordination within both the artificial and the sound lower limb. We analyzed kinematic strategies in amputees using the planar covariation of lower limb segments approach. When the elevation angles of the thigh, shank and foot are plotted one versus the others, they describe a regular loop which lies close to a plane in normal adults' gait. Orientation of this plane changes with increased speed, in relation to mechanical energetic saving. We used an opto-electronic device to record the elevation angles of both limbs' segments of novice and expert transfemoral amputees and compared them to those of control subjects. The statistical structure underlying the distribution of these angles was described by principal component analysis and Fourier transform. The typical elliptic loop was preserved in prosthetic walking, in both limbs in both novice and expert transfemoral amputees. This reflects a specific control over the thigh elevation angle taking into account knowledge of the other elevation angles throughout the gait cycle. The best-fitting plane of faster trials rotates around the long axis of the gait loop with respect to the plane of slower trials for control subjects, and even more for the sound limb of expert amputees. In contrast, plane rotation is very weak or absent for the prosthetic limb. We suggest that these results reveal a centrally commanded compensation strategy.