Postural asymmetries in transfemoral amputees

Postural asymmetries are thought to lead to impairment of body structure and function such as muscle imbalance, gait asymmetry and possible chronic conditions, which result in limitation of mobility and restriction of daily activity for transfemoral amputees (TFAs). Despite the potential clinical impact, postural asymmetries have not been confirmed or quantified in TFAs. To identify the presence of postural asymmetries in TFAs utilizing clinical evaluation measures. An observational cross-sectional study in which participants were evaluated at a single time point without intervention or follow-up. Forty-seven unilateral TFAs were measured for standing limb length, pelvic innominate inclination (PII), lateral trunk flexion and hip extension. Limb length discrepancy was present in 66% of participants and 57% had a short prosthetic limb. PII was greater than has been reported in the literature, and the shorter the prosthetic lower limb, the greater the PII on the amputated side (r = -0.422, p = 0.004). Limb length discrepancy and decreased lateral trunk flexion accounted for 26% of the variance in amputated side PII. Three postural measurements, namely leg length, pelvic innominate inclination and hip extension, were found to differ between the intact and amputated limb in this study sample. Clinicians should include postural assessment as part of their routine evaluation of TFAs in an effort to achieve postural symmetry and reduce the risk of chronic conditions associated with impairment of body structure and function.