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This study identified clinical (e.g., etiology) and demographic factors related to prosthesis use in persons with upper- and lower-limb amputation (ULA and LLA, respectively) and the effect of phantom limb pain (PLP) and residual limb pain (RLP) on prosthesis use. A total of 752 respondents with LLA and 107 respondents with ULA completed surveys. Factors related to greater use (hours per day) for persons with LLA included younger age, full- or part-time employment, marriage, a distal amputation, an amputation of traumatic etiology, and an absence of PLP. Less use was associated with reports that prosthesis use worsened RLP, and greater prosthesis use was associated with reports that prosthesis use did not affect PLP. Having a proximal amputation and reporting lower average PLP were related to greater use in hours per day for persons with an ULA, while having a distal amputation and being married were associated with greater use in days per month. Finally, participants with LLA were significantly more likely to wear a prosthesis than those with ULA. These results underscore the importance of examining factors related to prosthesis use and the differential effect that these variables may have when the etiology and location of amputation are considered. [ABSTRACT FROM AUTHOR]

The movement of the center of mass (COM) during human walking has been hypothesized to follow a sinusoidal pattern in the vertical and mediolateral directions. The vertical COM displacement has been shown to increase with velocity, but little is known about the mediolateral movement of the COM. In our evaluation of the mediolateral COM displacement at several walking speeds, 10 normal subjects walked at their self-selected speed and then at 0.7, 1.0, 1.2, and 1.6 m/s in random order. We calculated COM location from a 15-segment, full-body kinematic model using segmental analysis. Mediolateral COM displacement was 6.99 +/- 1.34 cm at the slowest walking speed and decreased to 3.85 +/- 1.41 cm at the fastest speed (p < 0.05). Vertical COM excursion increased from 2.74 +/- 0.52 at the slowest speed to 4.83 +/- 0.92 at the fastest speed (p < 0.05). The data suggest that the relationship between the vertical and mediolateral COM excursions changes substantially with walking speed. Clinicians who use observational gait analysis to assess walking problems should be aware that even normal individuals show significant mediolateral COM displacement at slow speeds. Excessive vertical COM displacement that is obvious at moderate walking speeds may be masked at slow walking speeds. [ABSTRACT FROM AUTHOR]

Background: Evaluating shoes during sport-related movements may provide a better assessment of plantar loads associated with repetitive injury and provide more specific data for comparing shoe cushioning characteristics., Hypothesis: Accelerating, cutting, and jumping pressures will be higher than in straight running, differentiating regional shoe cushioning performance in sport-specific movements., Study Design: Controlled laboratory study., Materials and Methods: Peak pressures on seven anatomic regions of the foot were assessed in 10 male college athletes during running straight ahead, accelerating, cutting left, cutting right, jump take-off, and jump landing wearing Speed TD and Air Pro Turf Low shoes (Nike, Beaverton, Ore). Pedar insoles (Novel, Munich, Germany) were sampled at 99 Hz during the 6 movements., Results: Cutting and jumping movements demonstrated more than double the pressure at the heel compared with running straight, regardless of shoe type. The Air Pro Turf showed overall lower pressure for all movement types (P<.0377). Cutting to the left, the Air Pro Turf shoe had lower heel pressures (36.6 +/- 12.5 N/cm(2)) than the Speed TD (50.3 +/- 11.2 N/cm(2)) (P<.0001), and the Air Pro Turf had lower great toe pressures than the Speed TD (44.8 +/- 8.1 N/cm(2) vs 54.4 +/- 8.4 N/cm(2); P= .0002). The Air Pro Turf also had significantly lower pressures than the Speed TD at the central forefoot during acceleration (38.2 +/- 8.3 N/cm(2) vs 50.8 +/- 7.4 N/cm(2); P<.0001)., Conclusion: Sport-related movements load the plantar surface of the foot more than running straight. Shoe cushioning characteristics were more robustly assessed during sport-related movements (4 significant results detected) compared with running straight (1 significant result detected)., Clinical Relevance: There is an interaction between shoe cushioning characteristics and sport-related movements that may influence plantar pressure and repetitive stress injuries.