Gait adaptations during walking under visual and cognitive constraints - Astudy of patients recovering from limb-saving surgery of the lower limb

The objective of this case series study was reautomatization of gait after limb-saving surgery for tumors at a laboratory of gait analysis. Twelve pat ients (9 males and 3 females; mean age, 38 years) who underwent limb-saving surgery of the lower limb at least 1 year previously and ten normal subjec ts (3 males and 7 females; mean age, 37.5 years) were studied. The main out come measures were walking speed and stride time duration under normal walk ing conditions as well as the use of different types of constraints. Patien ts walked with a lower preferred walking speed than the normal subjects. Pa tients showed a higher coefficient of variation of stride time in normal wa lking as well as complex walking compared with normal subjects. During walk ing with constraints, a significant decrease in stride time was found in pa tients but not in normal subjects. Although restoration of gait after limb- saving surgery is impressive, it is not complete (lower walking speed) and can break down under conditions of visual and cognitive load. Hence, the ap plication of complex tasks reveals that gait reautomatization is not comple te in these patients during a period of 2 to 5 years after surgery.