Background: The AMP Registry was set up in Germany to monitor routine care following lower limb loss. In this clinical context, the assessment of gait via marker-based 3D movement analysis is typically too time-consuming. Feasibility and face validity of an innovative markerless approach were therefore tested. Objectives: This study evaluated the feasibility and face validity of time-distance parameters, joint kinematics, and kinetics, as outcomes from the Theia3D markerless movement analysis system in routine medical assessments. Study Design: A single-center, prospective study was conducted, including participants with transtibial and transfemoral amputations, as well as a reference group of typically developed adults. Methods: The gait of 19 participants with transtibial amputations and 20 participants with transfemoral amputations was assessed via markerless 3D motion capture. Descriptive statistics were performed according to amputation level. Results: The characteristics of prosthetic gait after transtibial and transfemoral amputation, as determined by markerless gait analysis, were consistent with earlier findings in the literature obtained via traditional marker-based motion capture, thereby validating this novel method. Furthermore, the measurement time was reduced to 15 minutes. Conclusions: Markerless 3D motion capture is a promising tool for assessing gait in routine prosthetic care of patients after limb loss. However, post-processing times of up to 2 hours still need to be reduced for the method to be used in clinical practice. Clinical Relevance Statement: Detailed assessment of gait via 3D methods allows for a refined documentation of functional deficits in patients after limb loss, helping to improve prosthetic care and training.
Background and aim: Lower limb amputation leads to considerable physical, psychological, and social outcomes that significantly impact health-related quality of life (HRQoL). The objective of this study was to evaluate the performance of the Albanian SF-36v2 as a measurement tool to assess HRQoL among individuals with lower limb amputation living in Kosovo. Methods: We conducted a cross-sectional study using data collected between January and July 2012 at the Department of Prosthetics and Orthotics, Clinic of Physical Medicine and Rehabilitation, University Clinical Center of Kosovo. A total of 150 adults with unilateral lower limb amputation were included. The Albanian SF-36v2 was used to measure HRQoL, while the Prosthetic Evaluation Questionnaire-Mobility Scale (PEQ-MS) was used to measure prosthetic mobility. Norm-based scoring was applied, and internal consistency and construct validity were examined. A mental component score score ≤42 was used to indicate a risk for depressive symptomatology. Results: The mean age of participants was 44.2 ± 13.5 years, and 84% were male. Norm-based scoring revealed that both physical component summary (46.34) and mental component summary (41.64) scores were low in comparison to normal population scores, and more so for the mental health domain. Nearly half of the participants (47.3%) were classified as being at risk for depression. Physical domains, pain, and pain interference were scoring close to normal population levels, whereas vitality, social functioning, role emotional, and mental health domains were more divergent. The SF-36v2 demonstrated acceptable internal consistency and coherent domain score distributions. Conclusions: The Albanian SF-36v2 was a highly effective and practical tool in assessing health-related quality of life among lower limb amputees, highlighting the importance of mental health burden and well-being, and not only physical function and mobility.
Introduction: Satisfaction with prosthetic devices is a key determinant of functional outcomes and quality of life in individuals with lower-limb amputation. Donning and doffing a prosthesis are essential daily activities that may influence user satisfaction and clinical decision-making. However, no validated Persian instrument is currently available to specifically assess these aspects. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Prosthesis Donning and Doffing Questionnaire (PDDQ) in individuals with transtibial amputation. Materials and Methods: This cross-sectional repeated-measures study included 104 individuals with transtibial amputation. The translation and cultural adaptation followed established guidelines, including forward and backward translation, expert committee review, and pilot testing. Reliability was assessed using internal consistency and test–retest reliability (n = 33; 7–14-day interval). Concurrent validity was evaluated by examining correlations between the Persian version of the PDDQ (P-PDDQ) and the Trinity Amputation and Prosthesis Experience Scales. Known-groups validity was assessed based on different suspension systems. Results: The Cronbach’s alpha of the P-PDDQ obtained 0.62, showing close to acceptable range for internal consistency. Excellent test–retest reliability was demonstrated, with intraclass correlation coefficient values ranging from 0.91 to 0.99. Concurrent validity analysis showed no significant correlations between the total P-PDDQ score and Trinity Amputation and Prosthesis Experience Scales subscales, except for the functional satisfaction subscale ( P = 0.02). Known-groups validity revealed significant differences between participants using anatomical and pin/lock suspension systems in domains related to donning and doffing satisfaction. Conclusions: The P-PDDQ is a valid and reliable instrument for assessing satisfaction with prosthesis donning and doffing in individuals with transtibial amputation.
Background: Visual input is crucial for stable gait, particularly in individuals with transfemoral amputation (TFA) who lack somatosensory feedback from their TFA limb. Low-light conditions may further influence their walking patterns, increasing the risk of falls and joint disorders. Objective: This study examined the effect of ambient lighting on between-limb asymmetry during treadmill gait in individuals with TFA by assessing gait variability and joint biomechanics under regular and low-light conditions. Study Design: Observational study methods: Ten participants with unilateral TFA (six males, age = 36.9 ± 10.4 years, K level ≥ 3) walked at a self-selected speed on a split-belt treadmill under both lighting conditions. Outcomes measures included variability in spatiotemporal variables and sagittal trunk motion, as well as sagittal and frontal plane joint kinetics and kinematics. Two-way repeated-measure analysis of variance was conducted to examine limb asymmetries and limb × light interaction. Bonferroni-corrected post hoc analyses were performed when interaction effects were significant (α = 0.05). Results: Significant between-limb asymmetries were observed in step width variability and sagittal and frontal plane joint biomechanics across both lighting conditions. Under low-light conditions, these asymmetries were reflected by increasing the intact limb step width variability and peak internal hip extension moment, but a decrease in trunk flexion angular velocity variability. Conclusion: These results provide initial evidence that ambient lighting influences gait stability and joint loading in individuals with TFA. Our findings highlight that individuals with TFA are vulnerable to environmental challenges and the importance of considering lighting in designing interventions and fall-prevention strategies. Clinical Relevance: Clinically, attention to environmental lighting may be important when assessing gait, prescribing rehabilitation strategies, and designing fall-prevention interventions for this population. ( J Prosthet Orthot . 2026;X:XX–XX).
