Hip extension power and abduction power asymmetry as independent predictors of walking speed in individuals with unilateral lower-limb amputation

• Published in: Gait & posture Vol. 70; pp. 383 - 388
• Main Authors: Crozara, Luciano F., Marques, Nise R., LaRoche, Dain P., Pereira, Alessandro J., Silva, Francine C.C., Flores, Roberta C., Payão, Spencer L.M.
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.05.2019
• Subjects: Amputation; Isokinetic; Locomotion; Lower extremity; Muscle strength; Locomotion; Isokinetic; Lower extremity; Muscle strength; Amputation
• ISSN: 0966-6362; 1879-2219
• DOI: 10.1016/j.gaitpost.2019.03.033

•Lesser hip extension power on the amputated side is highly detrimental to PWS.•Asymmetry of hip abduction power between limbs is detrimental to PWS in individuals with LLA.•Hip flexors and extensors on the amputated side exhibited the poorest hip muscle performance.•Hip strength and power asymmetry between limbs varied between 20–30% in individuals with LLA. Preferred walking speed (PWS) is an indicator of walking ability, prosthetic walking potential, and function following a lower-limb amputation (LLA). There is a link between lower-limb muscle performance and PWS in individuals with LLA. However, the ability of select hip muscle performance parameters to determine PWS in these individuals still needs to be thoroughly investigated. Which hip muscle and joint torque parameters best determine PWS in persons with LLA? Seventeen patients with LLA (6 transfemoral, 4 knee disarticulation, and 7 transtibial; 16 men, 1 woman; mean age ± standard deviation, 56 ± 15yr) participated in this cross-sectional study. Maximal joint torque and power were evaluated unilaterally, for both amputated and intact limbs, in isometric and isokinetic conditions during hip flexion/extension (60°/s and 180°/s) and abduction/adduction (30°/s and 90°/s). PWS was measured at habitual walking speed over a 10-m distance. Pearson's correlation coefficient was used to verify the degree of association between each torque parameter and PWS and multiple regression analysis was performed to identify the best predictors of PWS. The level of significance was p < 0.05. Correlations between hip muscle performance parameters and PWS were found in most cases (r = 0.51–0.82; p ≤ 0.036–0.0005). The multiple regression model revealed that the best independent predictors of PWS were hip extension power at 180°/s on the amputated side (r² = 0.672; p < 0.0005) and the asymmetry of hip abduction power at 30°/s (r² = -0.147; p < 0.008), accounting together for 82% of the variance in PWS. Lesser hip extension power on the amputated side and greater hip abduction power asymmetry between limbs are detrimental to PWS in persons with LLA. These muscle groups and performance parameters should be considered during gait rehabilitation to assist individuals with LLA in achieving functional waking speed.