What is it about?

This article examines people with an above-the-knee amputation. An amputation represents a significant physical limitation at different levels. For example, at this level of amputation, the lower limb loses the knee joint and the ankle joint and foot with all their functions. Accordingly, a prosthesis must replace these functions. At the same time, it must be ensured that the interface with the user's body, the so-called socket, provides good support and thus good control of the prosthesis. This study investigated the extent to which walking, or deviations in walking, is related to a change in the status of the muscles surrounding the hip on the affected side.

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Why is it important?

Contrary to what is often assumed, lower limb prostheses are not active and powered, but are moved by the remaining muscles in the user's residual limb. Accordingly, the muscle status of the affected side is of high interest in people with an above-the-knee amputation. Due to the amputation, these muscles are partially disturbed in their function. Some of the points to which the muscles were attached are lost during the amputation. You can imagine this similar to a suspension bridge. Here, ropes brace the roadway. If ropes are damaged, the bridge can no longer absorb tensile forces in this area and it can no longer perform its function. The situation is similar with the human musculature. Here, the leg muscles brace the leg in such a way that the leg is stabilised. In the case of an amputation, the tension is disturbed and the muscles can no longer work properly in some cases, they receive less or different stimuli and therefore grow less.


Relationships between muscle strength and gait quality were shown. At the same time, the study also underlines that gait quality is not solely dependent on muscle status or strength, but on many other factors, such as how well the socket fits, the general constitution of the person and their ability in balance and coordination. Therefore, an intervention should not only be based on muscle training, but also include balance and functional training.

Daniel Heitzmann
Heidelberg University Hospital

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This page is a summary of: The influence of hip muscle strength on gait in individuals with a unilateral transfemoral amputation, PLoS ONE, September 2020, PLOS, DOI: 10.1371/journal.pone.0238093.
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