Investigacion

Gait & Posture 33 (2011) 511–526

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Gait & Posture
journal homepage: www.elsevier.com/locate/gaitpost

Review

Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review
´ Yoshimasa Sagawa Jr.a,b,c,*, Katia Turcot f, Stephane Armand f, Andre Thevenon b,d,e, Nicolas Vuillerme g,h, Eric Watelain a,b,c,i
aUVHC, LAMIH, F-59313 Valenciennes, France Univ Lille Nord de France, F-59000 Lille, France CNRS, FRE 3304, F-59313 Valenciennes, France d Physical Medicine and Rehabilitation Department, Lille University Hospital, Lille, France e Laboratory of Human Movement Studies, Faculty of Sports Sciences and Physical Education, Lille, France f Willy Taillard Laboratory of Kinesiology, Geneva UniversityHospitals and Geneva University, Geneva, Switzerland g ´ ´decine, La Tronche, France Laboratoire TIMC-IMAG UMR UJF CNRS 5525. Equipes ARFIRM/AGIM3, Faculte de Me h ˆpital Raymond Poincare EA 4497, Garches, France ´, CIC-IT 805, INSERM/AP-HP, Ho i HandiBio, EA 4322, Univ du Sud Toulon Var, La Garde, France
b c

A R T I C L E I N F O

A B S T R A C T

Article history: Received 13 July 2010Received in revised form 3 February 2011 Accepted 6 February 2011 Keywords: Amputee Biomechanics Physiological Gait Lower limb Prosthesis

Objective: : The purpose of this systematic review was to identify which biomechanical and physiological parameters are the most relevant, commonly used, able to discriminate and/or have specific clinical relevance for the gait analysis of lower-limb amputees (LLA).Methods: : We performed an electronic search via the PubMed, EMBASE and ISI Web of Knowledge databases from 1979 to May 2009. Two independent reviewers assessed the title and abstract of each identified study. The quality assessment of the full text was undertaken using a 13-item checklist divided into three levels: A, B, and C. Results: : The literature search identified 584 abstracts to beconsidered. After applying the inclusion criteria, we reviewed the full text of a total of 89 articles. The mean article quality was 8 Æ 2. No A-level article was found; the primary reason was a negative score in blinded outcome assessment. Sixty-six articles (74%) corresponded to a B-level, and two articles (2%) corresponded to a C-level. Twenty-one articles (24%) did not acquire enough points to beassigned to any level. In this study, we present and discuss the most commonly used and most relevant 32 parameters. Many of the parameters found were not reported in enough studies or in enough detail to allow a useful evaluation. Conclusion: : This systematic review can help researchers compare, choose and develop the most appropriate gait evaluation protocol for their field of study, based on thearticles with best scores on the criteria list and the relevance of specific biomechanical and physiological parameters. ß 2011 Elsevier B.V. All rights reserved.

1. Introduction In 2007, approximately 1.7 million people experienced limb loss in the United States [1]. In this country, more than 185,000

Abbreviations: AB, able-bodied; EMG, electromyography; FS, fast speed; GRF, ground reactionforce; LLA, lower-limb amputees; NS, normal speed; ROM, range of motion; SACH, solid ankle cushion heel; TF, transfemoral amputation; TT, transtibial amputation. ´ * Corresponding author at: Laboratoire d’Automatique et de Mecanique ´ d’Informatique Industrielles et Humaines (FRE CNRS 3304) Universite le Mont ˆ Houy, Batiment Malvache, 59313 Valenciennes cedex 9, France. Tel.: +33 (0) 665177936/327511349; fax: +33 (0) 3 27511317. E-mail address: Yoshimasa.SagawaJunior@meletu.univ-valenciennes.fr (Y. Sagawa Jr.). 0966-6362/$ – see front matter ß 2011 Elsevier B.V. All rights reserved. doi:10.1016/j.gaitpost.2011.02.003

new amputations are performed each year [1,2]. The prevalence rate in 1996 was 4.9 per 1000 persons. The prevalence rate was higher for people aged 65 years and older:...