Changes in Spatiotemporal Parameters and Lower Limb Coordination During Prosthetic Gait Training in Unilateral Transfemoral Amputees

When applying prosthetic gait training to patients with lower limb amputation, monitoring the gait change process is crucial for establishing and modifying rehabilitation training plans. In addition, since human gait involves complex movement of several joints, it is necessary to analyze the organic movement of adjacent joints rather than a single joint in the lower extremities for understanding the process of gait change. Therefore, this study aimed to analyze changes in spatiotemporal parameters and lower limb coordination during prosthetic gait training in unilateral transfemoral amputees (TFAs). This retrospective case-control study included 10 unilateral TFAs and 10 healthy individuals as controls. TFAs received prosthetic gait training for 12 weeks and gait changes were analyzed every 2 weeks using a 3D motion analysis system. The measured variables were spatiotemporal parameters and the continuous relative phase between hip and knee joints. The highest improvement in walking speed was seen at week 4 of training, and the continuous relative phase was most symmetric at week 8. The lower limb coordination pattern was more in-phase in the TFAs than in the controls, and the coordination variability was also lower for the TFAs than for the controls. In addition, the rate of change in lower limb coordination of TFAs was lower than that of spatiotemporal parameters and was significantly different from that of the controls even after training. Considering that the decrease in lower limb coordination is related to gait efficiency, balance, and risk of fall, there is a need to develop therapeutic strategies that can further improve the coordination of TFAs.