Northwestern University Feinberg School of Medicine

Northwestern University Prosthetics-Orthotics Center

Characterizing the Gait Biomechanics of Women with Leg Amputation for Improving Evidence-Based Rehabilitation Practice

Principal Investigator: Matthew J. Major, PhD

Research Assistants/Graduate Students: Jessica Yohay, BS

Clinical Faculty: Kristin Carnahan, MS, CPO 

CollaboratorsJesse Brown VA Medical Hospital Motion Analysis Research Laboratory, a NU CORE Facility; Rebecca Stine, MS

Funded byWomen’s Health Research Institute and the 2019 Shaw Family Pioneer Awards

Status: In progress 

Introduction

Characterizing the Gait Biomechanics of Women with Leg AmputationTo date, a systematic investigation on the effects of different heel heights and adjustable prosthetic feet on comfort, preference, and gait biomechanics of women with amputation has yet to be completed. It is essential to develop datasets that can guide the selection of adjustable feet for women prosthesis users and optimize prosthetic interventions to maximize ambulation safety and comfort.

In 2016, the National Institutes of Health (NIH) implemented a policy requiring investigators to consider sex as a biological variable (SABV) within their grant submissions and in 2017 the VA Clinical Practice Guidelines for Rehabilitation of Individuals with Lower Limb Amputation directed providers to “consider the patient’s birth sex and self-identified gender identity in developing individualized treatment plans”.

Evidence shows that women with amputations face rehabilitation challenges that are different than men. Overwhelmingly, men cohorts are convenience samples that dominate common research studies on rehabilitation outcomes and different prosthetic technology, thereby limiting generalizability and specific application to women.

Challenges in Footwear Choice

After a lower limb amputation, footwear perceived as appropriate is an important part of rehabilitation and community reintegration. Typically, women have more footwear options than men, with high heels a preferred part of many women’s attire. However, freedom of choice in footwear is limited for women prosthesis users.

 Össur Elation® prosthetic footMoreover, lower limb loss is known to alter gait biomechanics through compensatory mechanisms that can lead to secondary physical conditions. Thus, appropriate prosthetic prescriptions that optimize gait can help avoid chronic conditions.

The aims of this pilot study are to:

1. Develop a better understanding of the interaction between footwear and heel height on the gait of women with lower limb loss.

2. Generate data that will support future clinical studies. 

After completing IRB approval, subjects will be recruited and data will be collected in the NUPOC CORE Facility

Significance of SABV and Implications for Future Research

This pilot project contributes to a need for women-specific prosthetics research. Appropriate prosthetic prescriptions for women that optimize gait can help avoid chronic conditions, while greater variety in choice of footwear can improve quality of life after a lower limb amputation. This pilot study begins to address the critical need to advance rehabilitation practice for women with limb loss by generating data that will support future clinical studies. 

 

3rd Annual Celebration of Sex Inclusive Science 

Dr. Major's research award will be announced at the Women's Health Research Institute symposium, Considering the Role of Sex and Gender in Biomedical Research, on January 25, 2019.