الفهرس 
Analysis of Biomechanical Changes of Gait and Balance in Partial Foot Amputees and Non Amputees
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Abstract
Background: Partial foot amputation (PFA) is a common surgical loss of part
of either the forefoot or midfoot. It is usually the result of a cascade of
physiological foot dysfunctions such as peripheral neuropathy (PN). The gait
compensation mechanisms associated with these foot disorders weren‟t well
understood. Purpose: The aim of the study was to evaluate pathological gait
compensatory mechanisms in PFA due to PN versus PN alone through a
comprehensive analysis of gait kinematics, kinetics, and balance. Methods:
Gait kinetics, kinematics, spatiotemporal parameters, and overall stability index
were measured on 66 participants assigned into two groups; (A) PN group: 34
subjects with PN with neither ulcer nor amputation and (B) PFA Groups: 32
subjects with healed unilateral PFA. The gait analysis was conducted at a selfpreferred
speed using FREEMED baropodometric system, CLINICAL 3DMA
system, link-segment model, and Biodex balance system SD. Results: The PFA
group had a significantly lower surface area and load of the remaining toes and
metatarsal heads and less plantar flexion ROM during pre-swing than PN group
(p < 0.05). On the other hand, PFA showed a significant increase in peak plantar
pressure during mid-stance and late stance and in posture sway than the PN
group (p < 0.05). All the other measured variables showed no significant
difference between the two groups (p > 0.05). Conclusion: Both groups tend to
shift their body loads posteriorly and redistribute their loads to compensate for
the insufficient support over the forefoot, but the compensation was greater in
PFA compared to PN. The PFA surgery may not be the primary cause of the
alteration of the gait pattern but the underlying systemic disease, the PFA may
only worsen the compensatory mechanism.