{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:43:20Z","timestamp":1791463400009,"version":"4.3.4"},"reference-count":35,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Federal Ministry for Economic Affairs and Climate Action (BMWK)","award":["KK5335801BA1"],"award-info":[{"award-number":["KK5335801BA1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Minor amputations are increasingly relevant due to a growing proportion of lower limb amputations but remain underrepresented in research. These amputations impair mobility due to altered gait, and biomimetic devices could potentially address this issue. Fundamental research is needed to better understand this pathological gait pattern. The aim of this study is to analyse the holistic gait characteristics of the lower extremity during barefoot walking in individuals with different levels of minor amputations for the first time. Methods: Eight young to middle-aged subjects with minor foot amputations (four \u00d7 hallux; four \u00d7 forefoot) underwent instrumented gait analysis. Kinematic and kinetic data were acquired barefoot at self-selected gait speeds. Individual gait characteristics were considered relative to the physiological gait represented by the 95% confidence interval of ten unimpaired volunteers. Results: Subjects with a minor amputation show reduced walking speed and shorter stride length compared to controls. Sagittal ankle moment and ankle power are lower, with greater deficits in subjects with a forefoot amputation. Proximal joints also show variability, notably reduced knee flexion in subjects with a forefoot amputation and a more flexed hip profile in six subjects. Single-subject frontal plane kinetics also vary. Conclusions: Although the subjects with a hallux amputation exhibit smaller deviations in ankle kinetics than the subjects with a forefoot amputation, proximal joint abnormalities are present across cases. These findings highlight the need for a broad range of care to adequately address individual needs.<\/jats:p>","DOI":"10.3390\/jcm14072140","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T07:25:00Z","timestamp":1742541900000},"page":"2140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Gait Characteristics of People with Hallux and Forefoot Amputations\u2014A Case Series"],"prefix":"10.3390","volume":"14","author":[{"given":"Frithjof","family":"Doerks","sequence":"first","affiliation":[{"name":"Laboratory of Biomechanics and Biomaterials, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Gempfer","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics and Biomaterials, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0066-0340","authenticated-orcid":false,"given":"Magnus","family":"Reulbach","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics and Biomaterials, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eike","family":"Jakubowitz","sequence":"additional","affiliation":[{"name":"Laboratory of Biomechanics and Biomaterials, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Spoden, M., Nimptsch, U., and Mansky, T. (2019). Amputation Rates of the Lower Limb by Amputation Level\u2014Observational Study Using German National Hospital Discharge Data from 2005 to 2015. BMC Health Serv. Res., 19.","DOI":"10.1186\/s12913-018-3759-5"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Walter, N., Alt, V., and Rupp, M. (2022). Lower Limb Amputation Rates in Germany. Medicina, 58.","DOI":"10.3390\/medicina58010101"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1001\/jamasurg.2014.1007","article-title":"Fifteen-Year Trends in Lower Limb Amputation, Revascularization, and Preventive Measures Among Medicare Patients","volume":"150","author":"Goodney","year":"2015","journal-title":"JAMA Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1136\/bjsports-2022-105650","article-title":"Association between the Level of Partial Foot Amputation and Gait: A Scoping Review with Implications for the Minimum Impairment Criteria for Wheelchair Tennis","volume":"57","author":"Williamson","year":"2023","journal-title":"Br. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1053\/j.jfas.2017.07.015","article-title":"Does First Ray Amputation in Diabetic Patients Influence Gait and Quality of Life?","volume":"57","author":"Aprile","year":"2018","journal-title":"J. Foot Ankle Surg."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Forczek-Karkosz, W., Taylor, S., Kicka, A., Cappellini, G., Dewolf, A.H., and Ivanenko, Y. (2021). Adjustments in the Range of Angular Motion during Walking after Amputation of the Toes: A Case Report. Symmetry, 13.","DOI":"10.3390\/sym13112065"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1097\/01.PHM.0000107483.39213.24","article-title":"Transmetatarsal Amputation Prosthesis with Carbon-Fiber Plate: Enhanced Gait Function","volume":"83","author":"Tang","year":"2004","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.gaitpost.2022.11.064","article-title":"Pathological Gait in Partial Foot Amputation versus Peripheral Neuropathy","volume":"100","author":"Elabd","year":"2023","journal-title":"Gait Posture"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/00003086-198801000-00026","article-title":"Amputation of the Great Toe. A Clinical and Biomechanical Study","volume":"226","author":"Mann","year":"1988","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s13256-024-04444-z","article-title":"Biomechanical Gait Analysis and Rehabilitation in a Traumatic Hallux Deficit Patient: A Case Report","volume":"18","author":"Doi","year":"2024","journal-title":"J. Med. Case Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S1083-7515(03)00090-1","article-title":"Orthotic and Prosthetic Devices in Partial Foot Amputations","volume":"6","author":"Philbin","year":"2001","journal-title":"Foot Ankle Clin."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.fcl.2010.04.004","article-title":"Shoes, Orthoses, and Prostheses for Partial Foot Amputation and Diabetic Foot Infection","volume":"15","author":"Janisse","year":"2010","journal-title":"Foot Ankle Clin."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0966-6362(98)00015-0","article-title":"Differences in the Gait Characteristics of People with Diabetes and Transmetatarsal Amputation Compared with Age-Matched Controls","volume":"7","author":"Mueller","year":"1998","journal-title":"Gait Posture"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1682\/JRRD.2010.09.0167","article-title":"Effect of Prosthetic Design on Center of Pressure Excursion in Partial Foot Prostheses","volume":"48","author":"Dillon","year":"2011","journal-title":"JRRD"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1682\/JRRD.2008.02.0025","article-title":"Comparison of Gait of Persons with Partial Foot Amputation Wearing Prosthesis to Matched Control Group: Observational Study","volume":"45","author":"Dillon","year":"2008","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1080\/03093640500467480","article-title":"Can Partial Foot Prostheses Effectively Restore Foot Length?","volume":"30","author":"Dillon","year":"2006","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1177\/107110070602700207","article-title":"Preservation of Residual Foot Length in Partial Foot Amputation: A Biomechanical Analysis","volume":"27","author":"Dillon","year":"2006","journal-title":"Foot Ankle Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gaitpost.2019.06.024","article-title":"Prosthetic Restoration of the Forefoot Lever after Chopart Amputation and Its Consequences onto the Limb during Gait","volume":"73","author":"Kaib","year":"2019","journal-title":"Gait Posture"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1111\/brv.12999","article-title":"Chasing Footprints in Time\u2014Reframing Our Understanding of Human Foot Function in the Context of Current Evidence and Emerging Insights","volume":"98","author":"Behling","year":"2023","journal-title":"Biol. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.gaitpost.2023.12.016","article-title":"Contribution of Various Forefoot Areas to Push-off Peak at Different Speeds and Slopes during Walking","volume":"108","author":"Doerks","year":"2024","journal-title":"Gait Posture"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1002\/jor.1100080310","article-title":"Measurement of Lower Extremity Kinematics during Level Walking","volume":"8","author":"Kadaba","year":"1990","journal-title":"J. Orthop. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.gaitpost.2009.05.020","article-title":"The Gait Profile Score and Movement Analysis Profile","volume":"30","author":"Baker","year":"2009","journal-title":"Gait Posture"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Pau, M., Capodaglio, P., Leban, B., Porta, M., Galli, M., and Cimolin, V. (2021). Kinematics Adaptation and Inter-Limb Symmetry during Gait in Obese Adults. Sensors, 21.","DOI":"10.3390\/s21175980"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Monfrini, R., Rossetto, G., Scalona, E., Galli, M., Cimolin, V., and Lopomo, N.F. (2023). Technological Solutions for Human Movement Analysis in Obese Subjects: A Systematic Review. Sensors, 23.","DOI":"10.3390\/s23063175"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1001\/jama.1992.03490220101046","article-title":"Gait Analysis: Normal and Pathological Function","volume":"268","author":"Perry","year":"1992","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/JPO.0b013e3180dca55f","article-title":"Partial Foot Amputations and Disarticulations: Surgical Aspects","volume":"19","author":"Bowker","year":"2007","journal-title":"JPO J. Prosthet. Orthot."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Henson, D.P., Edgar, C., Ding, Z., Sivapuratharasu, B., Le Feuvre, P., Finnegan, M.E., Quest, R., McGregor, A.H., and Bull, A.M.J. (2021). Understanding Lower Limb Muscle Volume Adaptations to Amputation. J. Biomech., 125.","DOI":"10.1016\/j.jbiomech.2021.110599"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.clinbiomech.2009.03.010","article-title":"Biomechanics of Walking with Silicone Prosthesis after Midtarsal (Chopart) Disarticulation","volume":"24","author":"Burger","year":"2009","journal-title":"Clin. Biomech."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3010","DOI":"10.1016\/j.jbiomech.2008.07.029","article-title":"Control of Knee Coronal Plane Moment via Modulation of Center of Pressure: A Prospective Gait Analysis Study","volume":"41","author":"Haim","year":"2008","journal-title":"J. Biomech."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.joca.2021.10.010","article-title":"Are Biomechanics during Gait Associated with the Structural Disease Onset and Progression of Lower Limb Osteoarthritis? A Systematic Review and Meta-Analysis","volume":"30","author":"Charlton","year":"2022","journal-title":"Osteoarthr. Cartil."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.gaitpost.2011.09.013","article-title":"Use of Gait Summary Measures with Lower Limb Amputees","volume":"35","author":"Kark","year":"2012","journal-title":"Gait Posture"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s13643-019-1063-z","article-title":"Effects of Walking Speed on Gait Biomechanics in Healthy Participants: A Systematic Review and Meta-Analysis","volume":"8","author":"Fukuchi","year":"2019","journal-title":"Syst. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.gaitpost.2009.09.013","article-title":"The Change of Gait Parameters during Walking at Different Percentage of Preferred Walking Speed for Healthy Adults Aged 20\u201360 Years","volume":"31","author":"Chung","year":"2010","journal-title":"Gait Posture"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.gaitpost.2005.06.011","article-title":"Comparison of 3D Joint Moments Using Local and Global Inverse Dynamics Approaches among Three Different Age Groups","volume":"23","author":"Liu","year":"2006","journal-title":"Gait Posture"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbiomech.2018.04.017","article-title":"Ankle and Foot Power in Gait Analysis: Implications for Science, Technology and Clinical Assessment","volume":"75","author":"Zelik","year":"2018","journal-title":"J. Biomech."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/7\/2140\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:57:47Z","timestamp":1760029067000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/7\/2140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,21]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14072140"],"URL":"https:\/\/doi.org\/10.3390\/jcm14072140","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,21]]}}}