External loading comparisons between able-bodied and below-knee-amputee children during walking.

The purpose of this investigation was to determine external loading variables that could describe any statistically significant differences between the limbs of below-knee-amputee (BKA) and able-bodied children. Eleven able-bodied children and four BKA children volunteered to participate in this investigation. Force platform data were collected for two consecutive foot falls during two experimental sessions. Significant external load differences existed between the prosthetic limbs and nonprosthetic limbs of BKA children and between limbs of the BKA and able-bodied children. The prosthetic limb generally displayed a subordinate role when compared to nonprosthetic and normal limbs. The nonprosthetic limbs displayed a dominant role when compared to the other limbs. These external loading characteristics of the prosthetic and nonprosthetic limbs may be a logical consequence of the morphologic and functional differences that exist between the groups. It was concluded that as long as the prosthetic limb functions differently from a normal limb, BKA children may have a difficult time walking the same as able-bodied children. It would appear to be advantageous to determine the most appropriate gait pattern for BKA children, given the influence of such factors as prosthetic design, construction, and alignment, rehabilitation, and joint loading.