Adaptation to altered balance conditions in unilateral amputees due to atherosclerosis: a randomized controlled study

Mayer, Ágnes Andrea; Tihanyi, József; Bretz, Károly; Csende, Zsolt; Bretz, Éva; Horváth, Márton

doi:10.1186/1471-2474-12-118

Cited by 29 publications

(35 citation statements)

References 32 publications

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“…COP trajectory can be used to evaluate the adaptation of prosthetic and the rehabilitation progress of the patients with disable lower limbs [2, 3]. COP sway pattern can be utilized to study the influence on equilibrium impacted by visual signals.…”

Section: Introductionmentioning

confidence: 99%

The configuration of plantar pressure sensing cells for wearable measurement of COP coordinates

2016

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BackgroundWearable measurement of center of pressure (COP) coordinates is the key of obtaining the measurement of natural gait. Plantar pressure insole is the right sensing unit for plantar pressure monitoring for long-term outdoor measurements and the control of walking assisting exoskeleton robot. It’s necessary to study the configuration of pressure sensing cells.MethodsThis study explored the sensing cell configuration for the plantar pressure insole. The data of plantar pressure of walking is collected for layout variants. The RMSE of COP coordinates estimations are used as the evaluation criteria.ResultsThe RMSE of COP coordinates decreases from 8.00 to 3.20 mm as the amount of pressure sensing cells increases from 2 to 7. The size of pressure sensing cells contribute to reduce the RMSE of COP coordinates and 7 pressure sensing cells, with the size of 2.0–2.5 cm have the satisfying performance. Adding pressure sensing cell in the heel and hallux area increase the accuracy of estimating COP coordinates.ConclusionComparison results indicate that the configuration of 7 pressure sensing cells has a satisfying measurement performance.

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Section: Introductionmentioning

confidence: 99%

The configuration of plantar pressure sensing cells for wearable measurement of COP coordinates

2016

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“…These posturography studies have revealed increases in measures of postural sway including center of pressure velocity and displacement compared to age-matched controls [11–16]. These differences in postural sway are influenced by age [14,17], cause of limb loss [14], residual limb length [18], level of limb loss [11,15], and time since limb loss [19], but not prosthetic alignment [16,20]. Additionally, the intact leg may contribute substantially more to maintaining static postural stability than the prosthetic leg [21].…”

Section: 0 Introductionmentioning

confidence: 99%

Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control

Bolger

Ting

Sawers

2014

Clinical Biomechanics

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Background Deficits in balance control are one of the most common and serious mobility challenges facing individuals with lower limb loss. Yet, dynamic postural balance control among indivdiuals with lower limb loss remains poorly understood. Here we examined the kinematics and kinetics of dynamic balance in individuals with unilateral transtibial limb loss. Methods Five individuals with unilateral transtibial limb loss, and five age- and gender-matched controls completed a series of randomly applied multi-directional support surface translations. Whole-body metrics, e.g. peak center-of-mass displacement and net center-of-pressure displacement were compared across cohorts. Stability margin was computed as the difference between peak center-of-pressure and center-of-mass displacement. Additionally, center-of-pressure and ground reaction force magnitude and direction were compared between the prosthetic, intact, and control legs. Findings Peak center-of-mass displacement and stability margin did not differ between individuals with transtibial limb loss and controls for all perturbation directions except those loading only the prosthetic leg; in such cases the stability margin was actually larger than controls. Despite similar center-of-mass displacement, greater center-of-pressure displacement was observed in the intact leg during anterior-posterior perturbations, and under the prosthetic leg in medial-lateral perturbations. Further, in the prosthetic leg, ground reaction forces were smaller and spanned fewer directions. Interpretation Deficits in balance control among indivdiuals with transtibial limb loss may be due to their inability to use their prosthetic leg to generate forces that are equal in magnitude and direction to those of unimpaired adults. Targeting this force-generating deficit through technological or rehabilitation innovations may improve balance control.

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“…In addition, based on Mayer et al findings, the CoP sway was more prominence on ML axes compared to AP axes among the lower limb amputees. It was due to the reaction of both sides of hip joints to stabilize the body CoM as a compensation response to the loss of an ankle [25,26,31]. Besides that, lower limb amputees commonly have problem with weight shifting in effort to maintain the postural stability in medial-lateral aspect [35].…”

Section: Discussionmentioning

confidence: 99%

Effect of stump flexion contracture with and without prosthetic alignment intervention towards postural stability among transtibial prosthesis users

Ghazali

Razak

Osman

et al. 2017

IOP Conf. Ser.: Mater. Sci. Eng.

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Abstract. Knee flexion contracture on a stump side is a phenomenon in which the stump cannot move in normal range of motion (ROM) or cannot be fully extended. This study has been carried out by using Biodex Stability System (BSS) in order to investigate the effect of stump flexion contracture towards the postural stability among the transtibial prosthesis users with the intervention of alignment accommodation. The BSS provides the reading of anterior-posterior stability index (APSI), medial-lateral stability index (MLSI), and overall stability index (OSI). Higher reading of the index indicates lesser stability. Each of the subjects had been tested in three different sessions that were Visit 1 (before contracture improvement), Visit 2 (after contracture improvement without alignment readjustment), and Visit 3 (after contracture improvement with alignment readjustment). The APSI reading was significantly higher during Visit 2 compared to Visit 1 and Visit 3. The OSI during Visit 2 was also found significantly higher compared to Visit 3. In Visit 2, the degree of contracture was significantly improved with 44.1% less than Visit 1. The stability index in anterior-posterior aspect (APSI) was proven to be lower as the prosthetic alignment was adjusted according to the ROM of knee. This finding explained that the alignment set up based on the adaptation with the stump's ROM can contribute positively in maintaining postural stability. BackgroundKnee contracture or flexion contracture on the stump is one of the common problems occurred among the below knee amputees. It refers to the situation in which the patient cannot fully straighten the knee or in other words, the range of motion of the joint is limited from normal [1]. It is a result of the shortening and tightness of the muscles which might be associated with their structural changes due to the long period of bending position or inactivity due to the illness and lack of exercise [2]. The significant characteristics of contracture are limitation of joint mobility and increasing resistance of the joint to passive ROM which is the movement of joint applied by external power, either by someone or by exercise machine [3]. The mobility of joint is very important for a prosthetic candidate. This is because the limitation of joint motion which refers to joint contracture will significantly affect the fitting and function of the prosthesis [4].In overcoming the contracture, most of the efforts are focused on treating the contracture itself, decreasing the contracture angle or prevent it from becoming worse. For transtibial amputation cases, the amputees are advised to avoid placing pillow under the knee. An extension board is commonly used to be placed across the back of the knee joint to ensure the extension position [5]. Besides, stretching the soft tissues which can be done actively or passively is also very helpful to overcome the contracture.

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Adaptation to altered balance conditions in unilateral amputees due to atherosclerosis: a randomized controlled study

Cited by 29 publications

References 32 publications

The configuration of plantar pressure sensing cells for wearable measurement of COP coordinates

The configuration of plantar pressure sensing cells for wearable measurement of COP coordinates

Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control

Effect of stump flexion contracture with and without prosthetic alignment intervention towards postural stability among transtibial prosthesis users

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