RehabMove 2018: Gait deviations of people with a trans-femoral amputation, during "step by step" stair climbing

The majority of people with a unilateral trans-femoral amputation (PTFA) use the step by step strategy for stair climbing. In this study, the methods of PTFA to ensure foot, stair step clearance are investigated. 19 reference subjects (REF) and 6 PTFA were equipped with reflective markers. Subjects walked up an instrumented staircase using step by step strategy. PTFA had a reduced, but not significantly smaller, minimum foot, stair edge clearance compared to REF. PTFA showed a significantly smaller peak knee flexion, a significantly more extended hip and a greater anteriorly tilted pelvis and trunk during trailing limb in swing in comparison to REF. PTFA showed a significantly reduced dorsiflexion on the sound side during single support or involved side swing respectively, when compared to REF.  PTFA showed a significantly greater peak internal knee and hip extension moment of the sound side in comparison to REF during weight acceptance and pull up phases.For adequate foot, stair edge clearance; REF participants functionally shorten the trailing limb via an increased hip and knee flexion. PTFA are unable to use such “folding mechanism”. PTFA show therefore a greater pelvis and trunk anterior tilt, a more extended hip and even show a vaulting strategy of the sound side, during trailing limb swing. This may further lead to greater sound side hip and knee moments in PTFA in contrast to REF.