During gait retraining amputees can develop a number of gait deviations or variations. Each gait deviation has its own list of contributing factors that need to be navigated. In this below video we want to explore the causes of a unilateral or one sided step length reduction.
Hip Flexors
Amputee's are at risk of developing hip flexor muscle contractors. A hip flexor contracture limits the hips degree of extension during stance phase. Although the amputated side is more at risk than the non amputated side, hip flexor contractors are more commonly seen bilaterally and therefor would impact the step length of both sides.
Prosthesis Propulsion
Some people believe that a step length deformity is a result of the lack of propulsion generated from the prosthesis itself. This is a legitimate contributing factor to step length deficits but for the more noticeable step length deformities I tend to disagree that this is the main cause. The technology of prosthesis has come so far and they are quite good at generating propulsion. This is even in the case of the most basic prosthesis.
The 2 components that I believe are more commonly the cause of unilateral step length deformities are as follow:
Stump Pain
Stump pain will cause hesitation to weight bear during the stance phase of walking. This reduced standing time subsequently shortens the step length of the unaffected leg.
Stability
Stability similar to pain causes hesitation to weight bear during the stance phase of walking. This reduced standing time subsequently shortens the step length of the unaffected leg. Basically you are trying to get your other leg onto the ground as quickly as possible as you are not confident in your balance.
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Written By:
Tim Delvins
NDIS Physio Services - Amputee Physiotherapist