Kinematic Adaptations to a Novel Walking Task With a Prosthetic Simulator

The process of relearning locomotor skills is a complex one for the person with a lower-limb amputation. Tracking individuals from the moment they are fitted with a prosthesis until they become competent walkers is a difficult task to achieve with a group of lower-limb amputees. To counter this difficulty, a prosthetic simulator (PS) was designed and created in-house to allow able-bodied individuals to walk in a novel situation. The purpose of the current study was to follow the changes in gait variables during a novel walking task when lower-limb mechanics were altered. Kinematic data were collected from ten able-bodied individuals during 30 minutes of continuous walking with the PS without any instructions. Walking speed, body support times, step characteristics, and the vertical orientation of body segments were analyzed during one time constant, equivalent to 63% of final walking speed. Separate repeated-measures analyses of variance were conducted with p < 0.05. Participants were immediately able to walk unassisted with the PS. Walking speed was initially slow but increased significantly with time (p < 0.000). Time in stance was significantly greater on the intact limb (p < 0.000) and significantly decreased over distance (p < 0.000). Prosthetic step length was significantly longer than intact step length (p < 0.000). Lower-limb segments were significantly less vertically oriented at prosthetic/intact foot contact over time (p < 0.000). Participants were able to adapt quickly to the new locomotor constraints imposed by a PS by modifying kinematic variables. Changes in gait parameters occurred quickly and were retained throughout a 1-week period, suggesting that adaptive strategies were developed early in the task.