Markerless 3D Gait Analysis in Individuals with Lower-Limb Amputation in Routine Care: Spatiotemporal, Kinematic, and Kinetic Patterns According to the Level of Amputation

Background: The AMP Registry was set up in Germany to monitor routine care following lower limb loss. In this clinical context, the assessment of gait via marker-based 3D movement analysis is typically too time-consuming. Feasibility and face validity of an innovative markerless approach were therefore tested. Objectives: This study evaluated the feasibility and face validity of time-distance parameters, joint kinematics, and kinetics, as outcomes from the Theia3D markerless movement analysis system in routine medical assessments. Study Design: A single-center, prospective study was conducted, including participants with transtibial and transfemoral amputations, as well as a reference group of typically developed adults. Methods: The gait of 19 participants with transtibial amputations and 20 participants with transfemoral amputations was assessed via markerless 3D motion capture. Descriptive statistics were performed according to amputation level. Results: The characteristics of prosthetic gait after transtibial and transfemoral amputation, as determined by markerless gait analysis, were consistent with earlier findings in the literature obtained via traditional marker-based motion capture, thereby validating this novel method. Furthermore, the measurement time was reduced to 15 minutes. Conclusions: Markerless 3D motion capture is a promising tool for assessing gait in routine prosthetic care of patients after limb loss. However, post-processing times of up to 2 hours still need to be reduced for the method to be used in clinical practice. Clinical Relevance Statement: Detailed assessment of gait via 3D methods allows for a refined documentation of functional deficits in patients after limb loss, helping to improve prosthetic care and training.