Step activity and stride-to-stride fluctuations are negatively correlated in individuals with transtibial amputation

Jenny A. Kent, Nicholas Stergiou, Shane R. Wurdeman

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background Variability occurs naturally from stride to stride in healthy gait. It has been shown that individuals with lower limb loss have significantly increased stride-to-stride fluctuations during walking. This is considered indicative of movement disorganization and is associated with less healthy movement. Given that lower limb prosthesis users perform on average less physical activity than able bodied individuals, the purpose of this study was to determine whether increased fluctuations also correspond to a reduced level of activity in daily life. Methods Twenty-two transtibial amputees wore an activity monitor (Actigraph, Pensacola, FL, USA) for 3 weeks. Lower limb kinematics during treadmill walking were measured using a 12-camera motion capture system. The largest Lyapunov exponent (λ) was calculated bilaterally at the ankle, knee and hip to quantify the stride-to-stride fluctuations of the lower limb joints. Pearson correlations were used to identify the relationships between the average daily step count over the 3 week collection period and λ. Findings Significant, moderate negative correlations between daily step count and λ were found at the intact ankle (r = 0.57, P = 0.005), and the knee on the affected side (r = 0.44, P = 0.038). No such correlation was found at any other lower limb joint. Interpretation The negative correlation evident at these two joints demonstrates that increased stride-to-stride fluctuations are related to decreased activity levels, however it remains unclear whether these changes in the stride-to-stride fluctuations promote decreased activity or whether less active individuals do not gain sufficient motor learning experience to achieve a skilled movement.

Original languageEnglish
Pages (from-to)1225-1229
Number of pages5
JournalClinical Biomechanics
Issue number10
StatePublished - 1 Dec 2015
Externally publishedYes


  • Amputee
  • Biomechanics
  • Human movement variability
  • Lyapunov exponent
  • Rehabilitation


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