| Abstract [eng] |
BACKGROUND: Transfemoral amputation profoundly alters gait, often resulting in asymmetry, compensatory movement patterns, and increased musculoskeletal loading (Benton et al., 2024). Despite continuous progress in prosthetic knee technology, includ-ing the transition from mechanical to microprocessor-controlled systems, functional out-comes remain highly variable. A major challenge is that clinical decisions regarding pros-thesis selection and adjustment are often guided by observation and patient feedback ra-ther than objective biomechanical evidence (Persine et al., 2024). Without quantitative assessment, subtle gait deviations may go unnoticed until they contribute to long-term complications. Advanced biomechanical analysis provides an opportunity to capture pre-cise kinematic and kinetic data, offering measurable metrics that can enhance clinical decision-making, improve prosthesis fitting, and support individualized rehabilitation strategies. OBJECTIVE: To identify and evaluate biomechanical metrics that support clinical decision-making and enhance the individualization of prosthesis fitting in transfemoral amputees. METHODS: In the study of biomechanical gait characteristics, a subject with a left above-knee amputation (male, 32 years old, height 192 cm, weight 94 kg) volunteered to participate. The participant was evaluated using two different prosthetic knee systems: a mechanical knee and a microprocessor-controlled knee. For each condition, gait trials were repeated six times with 1–2-minute breaks between walks. Kinematic data were collected using a Qualisys motion analysis system with 12 Oqus 7 cameras operating at 120 Hz. Ground reaction forces were recorded using two AMTI force plates. Additional treadmill-based gait analysis was performed with the Rehawalk HP Cosmos system in combination with the Zebris FDM-T, which integrates a pressure sensor matrix operating at 120 Hz. RESULTS: Analysis revealed pronounced gait asymmetry with the mechanical knee, characterized by excessive pelvic obliquity of up to 12° on the prosthetic side. This was accompanied by shorter step length, reduced stance time, and asymmetric loading, indi-cating functional instability. In contrast, the microprocessor-controlled knee reduced pel-vic obliquity to 5°, with more balanced step length and improved stance phase duration. Load distribution between limbs became more symmetrical, and hip joint motion more closely matched normative patterns. CONCLUSIONS: This study demonstrated measurable gait differences, including kinematic and kinetic data. Motion analysis effectively identifies asymmetries and com-pensatory strategies that may not be visible through clinical observation alone. Integrating these data into clinical workflows can support evidence-based decisions, op-timize prosthesis alignment, and enhance individualized rehabilitation outcomes. |
