Clinical biomechanics (Bristol, Avon) · 2026
Long-term gait stability and adaptive mechanisms decades after rotationplasty: a gait analysis study.
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Krebbekx G G J, Waterval N F J, Duda M, Duivenvoorden M J C, Sierevelt I N, Bramer J A M, Kerkhoffs G M M J, Brehm M A, Verspoor F G M
Аннотация
BACKGROUND: Although rotationplasty patients typically regain good mobility, the altered anatomy, reduced muscle volume, and impaired proprioception may compromise gait stability. This study evaluated long-term gait stability in rotationplasty patients compared with a control group without lower limb pathology.
METHODS: In this cross-sectional study, 3D-gait analysis using a 12-camera Vicon system was performed at self-selected walking speed. Gait stability was quantified using temporal-spatial variability and the margin of stability (MoS) in mediolateral (ML) and anterior-posterior (AP) directions. Parameters were compared between the rotationplasty and contralateral limbs with a control group of eleven participants. Perceived balance and walking ability were assessed with the Prosthesis Evaluation Questionnaire. Associations between stability metrics and perceived outcomes were explored using Spearman correlations.
FINDINGS: Twenty-nine survivors (mean follow-up 32.3 years) were included. Compared with the control group, patients demonstrated greater step width (mean difference(MD) = 31.1 mm; p = 0.007) and step-width variability (MD = 7.8 mm; p < 0.001) and shorter stance time on the rotationplasty limb but longer on the contralateral limb (both p < 0.001). AP MoS were lower (MD = -68.6 and - 65.9 mm; both p < 0.001), whereas ML MoS were higher in people with rotationplasty (MD = 29.0 and 9.2 mm; both p = 0.049) compared with the control group. No significant correlations were found between gait stability measures and balance or ambulation questionnaire scores.
INTERPRETATION: Three decades after surgery, rotationplasty survivors exhibit reduced gait stability characterized by higher step width variability, and reduced AP MoS versus the control group. Higher ML MoS likely reflects a compensatory balance strategy.
METHODS: In this cross-sectional study, 3D-gait analysis using a 12-camera Vicon system was performed at self-selected walking speed. Gait stability was quantified using temporal-spatial variability and the margin of stability (MoS) in mediolateral (ML) and anterior-posterior (AP) directions. Parameters were compared between the rotationplasty and contralateral limbs with a control group of eleven participants. Perceived balance and walking ability were assessed with the Prosthesis Evaluation Questionnaire. Associations between stability metrics and perceived outcomes were explored using Spearman correlations.
FINDINGS: Twenty-nine survivors (mean follow-up 32.3 years) were included. Compared with the control group, patients demonstrated greater step width (mean difference(MD) = 31.1 mm; p = 0.007) and step-width variability (MD = 7.8 mm; p < 0.001) and shorter stance time on the rotationplasty limb but longer on the contralateral limb (both p < 0.001). AP MoS were lower (MD = -68.6 and - 65.9 mm; both p < 0.001), whereas ML MoS were higher in people with rotationplasty (MD = 29.0 and 9.2 mm; both p = 0.049) compared with the control group. No significant correlations were found between gait stability measures and balance or ambulation questionnaire scores.
INTERPRETATION: Three decades after surgery, rotationplasty survivors exhibit reduced gait stability characterized by higher step width variability, and reduced AP MoS versus the control group. Higher ML MoS likely reflects a compensatory balance strategy.