Assessing the Validity of Whole-Body and Segmental Angular Momenta During Walking in Older Individuals With and Without Transtibial Limb Loss

Older individuals (≥65 y old) with and without lower limb loss experience a high prevalence of falls. Minimizing fall risk depends on an individual's ability to maintain dynamic balance. A metric often used to characterize an individual's ability to regulate dynamic balance is angular momenta during steady-state walking. However, a gap exists in the validity of angular momenta as a measure of dynamic balance in these cohorts. The goal of this study was to evaluate the validity of angular momenta in older individuals with and without transtibial amputation during walking through assessments of construct and criterion validity. Construct and criterion validity were evaluated through correlations of momenta with clinical balance measures and prospective fall numbers over 12 months, respectively. For context, falls were categorized by pattern and scenario. Angular momenta of walking demonstrated evidence of construct and criterion validity in both groups through moderate-to-strong correlations with clinical balance measures and prospective falls. These relationships also varied between groups. The most common pattern and scenario of falls in both groups were trips and level-ground walking, respectively. This study contributes evidence that angular momentum during level-ground walking is a valid measure of dynamic balance in older persons with and without transtibial amputation.