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proLékaře.cz / Journals / The Clinician and Technology Journal / 2019 - 4

THE EFFECT OF SPEED ON GAIT ASYMMETRY IN SUBJECT WITH CONGENITAL TIBIAL DEFICIENCY: A CASE STUDY

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Authors: Jitka Marencakova;  Tomas Gryc;  Frantisek Zahalka
Authors‘ workplace: Sport research centre, Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
Published in: Lékař a technika - Clinician and Technology No. 4, 2019, 49, 112-118
Category:

Overview

Congenital tibial deficiency is a rare developmental skeletal disorder. When the surgical treatment fails the amputation and/or prosthesis is needed. Recent studies of prosthetic gait present only data for acquired case of prosthetic gait, mainly measured in comfortable self-selected speed, which does not reflect changes visible only during higher demands conditions i.e. faster gait. Prosthetic gait of acquired cases (i.e. traumatic amputation) differs from normal gait mostly in gait asymmetry (GA). However, it was not yet studied in a developmental case of prosthetic gait. In this case study, GA changes in different speed of walking with ankle-foot prosthesis were identified for unilateral congenital tibial deficiency in a young healthy man. Selected joint kinematic, spatial-temporal, and kinetic gait parameters were collected using 3D motion capture system and treadmill with force plate simultaneously. Mean values, SD, and symmetry indexes were calculated in different walking speeds and descriptively analyzed. Results show developmental prosthetic gait specific pattern and GA in most of the measured gait parameters. Kinematic parameters of joint angular ranges register decreasing GA with increasing gait speed on intact limb side. Spatial-temporal parameters present decreasing GA with increasing speed on the prosthetic limb side for double support and step duration. Kinetic parameters show increasing GA on intact limb in all parameters, except loading rate which decrease with increasing speed. In the case of congenital tibial deficiency, gait pattern, GA and compensatory mechanisms differ to the acquired prosthetic gait and depend on walking speed. These findings complete the missing point in prosthetic gait research and may serve as a base for further research of differences between developmental and acquired cases of prosthetic gait patterns.

Keywords:

Velocity – Walking – gait – symmetry index – prosthetic – congenital dysplasia of tibia – congenital tibial hemimelia – foot prosthesis – kinematic – kinetic – treadmill

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