The effects of altering initial ground contact in the running gait of an individual with transtibial amputation.

BACKGROUND: High rates of osteoarthritis of the knee joint of the intact limb in persons with amputation have raised concern about the long-term consequence of running. The purpose of this intervention was to determine if loading of the knee on the intact limb of a person with transtibial amputation during running could be decreased by changing the intact limb initial ground contact from rear foot to forefoot strike.

CASE DESCRIPTION AND METHODS: This study compared kinematic, kinetic and temporal-spatial data collected while a 27-year-old male, who sustained a traumatic unilateral transtibial amputation of the left lower extremity, ran using a forefoot ground contact and again while using a heel first ground contact.

FINDINGS AND OUTCOMES: Changing initial ground contact from rear foot strike to forefoot strike resulted in decreases in vertical ground reaction forces at impact, peak knee moments in stance, peak knee powers, and improved symmetry in step length.

CONCLUSION: This case suggests forefoot initial contact of the intact limb may minimize loading of the knee on the intact limb in individuals with transtibial amputation.