Spatiotemporal Parameters and Step Activity of a Specialized Stepping Pattern Used by a Transtibial Amputee During a Denali Mountaineering Expedition

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Abstract
Specialized mountaineering stepping patterns have not been studied in persons with transtibial amputation (TTA). The purpose of this report was to describe spatiotemporal differences between the specialized French technique and traditional stepping in an individual with TTA and report his step activity during a climbing expedition in Denali, AK, USA. A 51-year-old old man with TTA recorded step count and activities during a summit attempt on Mt. McKinley (Denali). After the climb, the subject traversed a GAITRite walkway simulating French and traditional stepping to compare spatiotemporal differences between stepping patterns. The climber completed 8 days on the trail, with a total step count of 62,421 and average daily count of 10,404. Approximately 27% of the steps were taken using the French technique. Five total events were logged: one dermatologic, three musculoskeletal events, and the culminating event was cardiovascular in nature, where the climber reported overheating and exertion requiring climb cessation and evacuation. For velocity, the French technique was slower than traditional stepping. Stride, step, and double support times were greater in the French technique compared with traditional stepping. Spatially, stride and step lengths were greater in the traditional compared with the French technique. The base of support width was wider in the French than in the traditional stepping. Musculoskeletal rather than dermatologic issues predominated in the event log. Fatigue ultimately concluded the climb, warranting further investigation into balancing component durability and mass in terms of prosthetic foot selection. As altitude increased, the French technique was selected as the preferred stepping strategy. The French technique is ultimately a slower stepping technique favoring stability over mobility.

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