A comparison of foot placement strategies of transtibial amputees and able-bodied subjects during stair ambulation

Abstract

Ambulation on stairs presents a significant challenge for lower extremity amputees and increases the risk of falling and sustaining a serious injury. This study aimed to compare foot placement and foot clearance during stair ambulation in a group of transtibial amputees and a group of able-bodied subjects. Three-dimensional motion analysis was used to determine foot positioning and to calculate temporospatial parameters during stair ascent and descent of 10 transtibial amputees (mean age = 56) and a control group consisting of 10 healthy able-bodied individuals (mean age = 26.7). No significant difference was observed in foot positioning and foot clearance between the amputee and control groups. Temporospatial data revealed a number of significant differences between the groups, particularly during stair ascent. Amputees were observed to walk with a slower velocity and cadence (p < 0.01), to increase the time spent in stance phase and double support (p < 0.01) and to increase their step width during both stair ascent and descent (p < 0.01). Results suggest that foot placement and clearance are not factors that would contribute to a stumble or fall on stairs in established amputees but that balance related issues, such as relative motion of the centre of mass, require further investigation.