Kinematic and kinetic adaptations in the lower limb during stance in gait of unilateral femoral neuropathy patients.

Abstract

This study aimed to quantify the impact of a unilateral femoral neuropathy on joint kinematic and kinetic strategies employed in the lower limbs during gait. The stance phase of gait of four subjects with proximal femoral nerve injury occurring 5-15 months previously was investigated with a video-based data collection system. Kinematic and kinetic data of the pelvis and lower limb segments were sampled unilaterally from both the involved and uninvolved lower extremities. Results revealed that the uninvolved limb demonstrated no clear compensatory strategies except for prolonged stance phase in three of the four subjects. In the involved limb the knee was maintained near full extension throughout much of the stance phase. This was accomplished by minimizing the posterior ground reaction force in early stance, increasing eccentric plantarflexor control of the tibia, and increasing concentric hip extensor control of the femur. These adaptations appeared to be more successful in the subject who was stronger in the uninvolved musculature. The strategies in the other three subjects appeared to be less effective, based on the subjects' slow velocity of gait, knee hyperextension, and use of assistive devices. Patients with femoral neuropathy must develop adaptations in the lower limbs to control knee joint position during gait. The kinematic and kinetic compensations described helped to provide insight into the nature of these adaptations. The relative success of these compensations in different subjects may guide the development of rehabilitation treatment programs for these patients.