The influence of limb alignment on the gait of above-knee amputees
Alignment of the above-knee prostheses is one of the important factors affecting the success of patient/prosthesis matching. It has been found that the prosthetist and the patient can accept a number of alignments which produce different intersegmental loads and it has been suggested that it is possible to obtain an 'optimal' alignment satisfying certain criteria. In order to enhance the efficiency of the alignment procedure, it is necessary to understand how alignment affects the amputee's gait and the patient compensations for changes in the alignment. Biomechanical gait tests on above-knee amputees were conducted in which the alignment of the prosthesis was changed systematically. The Strathclyde television-computer system was used to record the kinematic data of the amputee, and the ground reactions were measured by two Kistler forceplates. An 8-segment biomechanical model of the above-knee amputee was developed and implemented by a suit of FORTRAN computer programs to analyze and present 3-D kinematic and kinetic data obtained. The effects of alignment changes on the above-knee amputees' gait were studied in terms of the temporal-distance parameters, angular displacements of the lower limbs and the trunk, ground reactions and intersegmental moments. It was found that the angular displacement at the hip joint on the prosthetic side showed compensatory actions of the amputee for the alignment changes. The ground reaction force was sensitive to alignment changes, and in particular, the changes in the characteristics of the fore-aft ground force could be related to the alignment changes. The antero-posterior intersegmental moments about the prosthetic ankle and knee joints were evidently influenced by alignment.