A comparative study of limb load on the healthy side of above-knee amputees after reconstruction of assistive walking devices

Patients with above-knee amputations often experience postoperative secondary diseases in their unaffected leg, including reduced bone density, muscle atrophy, and osteoarthritis. These conditions arise due to altered limb load resulting from the amputation. Assistive walking devices offer additional support and can modify limb load. To assess the impact of different assistive devices on limb load in the unaffected leg, we conducted a study with 13 above-knee amputation patients and thirteen healthy individuals. Participants walked at a self-selected speed while using a prosthetic, single crutch, or double crutches. Gait analysis was performed using Qualisys motion capture and force plates, and kinematic and kinetic data were analyzed using custom OpenSim software. Our results indicate that the prosthetic group closely resembles the healthy group but exhibits differences in knee joint adduction moments and knee joint contact forces. Among the groups, the single-crutch group bears the highest load, while the double-crutches group has the lowest load, even lower than the healthy group. Bio-inspired prosthetics are recommended for long-term use, but optimizing kinematic symmetry through rehabilitation methods and prosthetic modifications is essential. Prolonged use of crutches should be minimized to reduce stress concentration, and resistance training is a suitable strategy.