Retrospective clinical analysis of gait asymmetry in unilateral transfemoral and transtibial amputees.

Authors

Keigo Yamauchi, Takashi Nakamura

Published in

Prosthetics and orthotics international. Aug 04, 2026. Epub Aug 04, 2026.

Abstract

Gait asymmetries and compensatory strategies are common among individuals with unilateral transfemoral (TF) and transtibial (TT) amputation. Although these characteristics have been widely described in the prosthetic gait literature, comparative evidence directly examining differences between the 2 amputation levels, particularly using large-scale clinical data derived from long-term databases, remains limited. This study aimed to clarify gait asymmetry characteristics in individuals with unilateral lower limb amputation by comparing spatiotemporal gait parameters between TF amputees and TT amputees.
A retrospective analysis was conducted on clinical gait data collected between 2013 and 2024 from 66 individuals at a Japanese rehabilitation center using a pressure-sensitive walkway system. Spatiotemporal parameters and symmetry indices (symmetry indices; a quantitative measure expressing interlimb differences as a normalized percentage difference between limbs) were calculated for each limb. Intergroup comparisons were conducted using the Mann-Whitney U test, and within-group comparisons of amputated vs. nonamputated limbs were performed using the Wilcoxon signed-rank test.
TT amputees exhibited significantly greater walking speed, cadence, and stride length than TF amputees. Temporal asymmetries were more pronounced in TF amputees, whereas spatial and support-related asymmetries were more evident in TT amputees. Stride length asymmetry was also identified in the TF group. Symmetry indices for stance and swing phase durations were significantly greater in the TF group, whereas those for step width and double support time were greater in the TT group.
Gait asymmetry patterns in lower limb amputees differ according to amputation level. TF amputees showed predominantly temporal asymmetry, whereas TT amputees demonstrated more marked spatial and support-related asymmetries. These findings support the clinical utility of symmetry indices in prosthetic gait assessment.

PMID:
42551028
Bibliographic data and abstract were imported from PubMed on 05 Aug 2026.

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