Kinematic gait analysis of a young man after amputation of the toes

Study aim: the foot is recognised as a “functional unit” with two important aims: to support body weight and to serve as a lever to propel the body forward. When it is impaired, the locomotor pattern has to adapt to compensate for the dysfunction. The purpose of this study was to investigate gait kinematics of a man after bilateral partial amputation of the toes.

Material and methods: the subject of the study was a young man aged 30 years (body height and mass: 186 cm, 82 kg) who suffered a frostbite injury in the feet while climbing in the severe mountain conditions. After a few months of treatment, the necessary amputation occurred. Three-dimensional lower limb kinematics was collected from motion capture system (Vicon 250) and Golem marker set-up using 5 video-based cameras with infrared strobes. The subject performed over-ground walking at self-selected speed, first barefoot, then wearing athletic shoes.

Results: the patient’s results are the mean values of sixteen full gait cycles. The spatiotemporal parameters were lower during gait without shoes. In terms of the angular changes of the lower limb joints in sagittal plane, the analysis revealed similar functional patterns and typical trends in both recorded conditions. The differences, however, occurred in their amplitude. A larger range of motion was generally noted in shod conditions. The higher the joint was, the smaller the differences were.

Conclusion: changes in gait due to the forefoot dysfunction may be stabilizing adaptations related to fear of falling. Footwear provided more stable conditions.