Gait adaptations during walking under visual and cognitive constraints - A study of patients recovering from limb-saving surgery of the lower limb

The objective of this case series study was reautomatization of gait after limb-saving surgery for tumors at a laboratory of gait analysis. Twelve patients (9 males and 3 females; mean age, 38 years) who underwent limb-saving surgery of the lower limb at least 1 year previously and ten normal subjects (3 males and 7 females; mean age, 37.5 years) were studied. The main outcome measures were walking speed and stride time duration under normal walking conditions as well as the use of different types of constraints. Patients walked with a lower preferred walking speed than the normal subjects. Patients showed a higher coefficient of variation of stride time in normal walking as well as complex walking compared with normal subjects. During walking with constraints, a significant decrease in stride time was found in patients but not in normal subjects. Although restoration of gait after limb-saving surgery is impressive, it is not complete (lower walking speed) and can break down under conditions of visual and cognitive load. Hence, the application of complex tasks reveals that gait reautomatization is not complete in these patients during a period of 2 to 5 years after surgery.