Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 1, 2015
   Pages 1 — 20

Abstract — Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

Hemakumar Devan, MPhty;1* Allan Carman, PhD;2 Paul Hendrick, PhD;3 Leigh Hale, PhD;1 Daniel Cury Ribeiro, PhD1

1Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand; 2Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New ??Zealand; 3Division of Physiotherapy and Rehabilitation Sciences, University of Nottingham, Nottingham, United Kingdom

Abstract — Following amputation, people with transfemoral amputation (TFA) and transtibial amputation (TTA) adapt with asymmetrical movements in the spinal and lower-limb joints. The aim of this review is to describe the trunk, lumbopelvic, and hip joint movement asymmetries of the amputated limb of people with TFA and TTA during functional tasks as compared with the intact leg and/or referent leg of nondisabled controls. Electronic databases were searched from inception to February 2014. Studies with kinematic data comparing (1) amputated and intact leg and (2) amputated and referent leg of nondisabled controls were included (26 articles). Considerable heterogeneity in the studies precluded data pooling. During stance phase of walking in participants with TFA, there is moderate evidence for increased trunk lateral flexion toward the amputated limb as compared with the intact leg and increased anterior pelvic tilt as compared with nondisabled controls. None of the studies investigated spinal kinematics during other functional tasks such as running, ramp walking, stair climbing, or obstacle crossing in participants with TFA or TTA. Overall, persons with TFA adapt with trunk and pelvic movement asymmetries at the amputated limb to facilitate weight transfer during walking. Among participants with TTA, there is limited evidence of spinal and pelvic asymmetries during walking.

Key words: activity of daily living, adaptation, amputation, biomechanics, compensation, functional task, kinematics, lower limb, transfemoral, transtibial.


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This article and any supplementary material should be cited as follows:
Devan H, Carman A, Hendrick P, Hale L, Ribeiro DC. Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review. J Rehabil Res Dev. 2015;52(1):1–20.
http://dx.doi.org/10.1682/JRRD.2014.05.0135
ResearcherID/ORCID: Hemakumar Devan, MPhty: G-9585-2012; Paul Hendrick, PhD: F-7325-2012; Daniel Cury Ribeiro, PhD: G-1694-2011
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