Kinematic and kinetic analysis of a stepping-in-place task in below-knee amputee children compared to able-bodied children

It has been demonstrated that below-knee amputee (BKA) subjects use specific compensation strategies to overcome their physical limitations. Biomechanical studies emphasize that the motor strategies adopted by BKA adults differ between their amputated limb and their nonamputated limb and from those employed by able-bodied (AB) subjects. The purpose of this investigation was to compare the motor solutions used by control AB and BKA children during a stepping-in-place (SIP) task and to assess how they regulate the coordination of their nonamputated and amputated limbs during this task. Eight BKA children and eight AB children paired for gender, age, weight and height participated in our study. One-way analysis of variances (ANOVAs) were performed on peaks of angular excursion, moment, and power at the hip, knee, and ankle to compare motor strategies between the BKA and AB groups. The main results of our experiment showed that even if BKA and AB children did the task with almost the same kinematics, the kinetic data revealed completely different mechanisms of the two groups to achieve the SIP task, and BKA children had a symmetrical interlimb strategy. SIP, a simple task compared to gait at the level of neuro-musculoskeletal demands, could thus offer a transition task to physical therapists for below-knee recently-amputated children.