Assessment of amputee socket–stump–residual bone kinematics during strenuous activities using Dynamic Roentgen Stereogrammetric Analysis

Papaioannou, George; Mitrogiannis, Christos; Nianios, G.; Fiedler, Goeran

doi:10.1016/j.jbiomech.2009.11.013

Cited by 47 publications

(27 citation statements)

References 27 publications

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“…First, the stiffness of residual limb tissues was estimated using a study that quantified three-dimensional (3D) bone–tissue movement in 10 persons with a transtibial amputation, landing from a height of 22 cm. 9 Data presented on participant 4 (92.2 kg) demonstrated the greatest displacement between the skin and tibia (24.16 mm) and represented a worst-case scenario for this investigation. 9 Using conservation of energy equations (equation (1)) based on a subject mass (92.2 kg), the change in center of mass height (0.22 m drop height), acceleration due to gravity (9.81 m/s 2 ), tissue displacement during that drop (0.025 m), and then solving for the spring constant returned the tissue stiffness of those residual limb tissues (~640,000 N/m).…”

Section: Methodsmentioning

confidence: 94%

“…9 Using conservation of energy equations (equation (1)) based on a subject mass (92.2 kg), the change in center of mass height (0.22 m drop height), acceleration due to gravity (9.81 m/s 2 ), tissue displacement during that drop (0.025 m), and then solving for the spring constant returned the tissue stiffness of those residual limb tissues (~640,000 N/m). Biological tissue stiffness behaves in a nonlinear fashion, especially when subjected to rapid decelerations like the drop test in Papaioannou et al 9 To account for this, the value for tissue stiffness was then scaled for gait to better approximate linear behavior around tissue displacements typical of gait. Equation (1) was used again, but this time to calculate the amount of tissue displacement that same individual would have during gait.…”

Section: Methodsmentioning

confidence: 99%

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Marker-based method to measure movement between the residual limb and a transtibial prosthetic socket

Childers

Siebert

2016

Prosthetics &Amp; Orthotics International

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Section: Methodsmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

Marker-based method to measure movement between the residual limb and a transtibial prosthetic socket

Childers

Siebert

2016

Prosthetics &Amp; Orthotics International

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“…These include X-ray [12,20,[23][24][25], spiral computerized tomography [26], and photoelectric sensors [22]. These measurement methods are mostly useful for measuring the bone movement inside the socket.…”

Section: Introductionmentioning

confidence: 99%

Transtibial prosthetic suspension: Less pistoning versus easy donning and doffing

Gholizadeh

Osman²,

Eshraghi³

et al. 2012

JRRD

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Abstract-Poor suspension increases slippage of the residual limb inside the socket during ambulation. The main purpose of this article is to evaluate the pistoning at the prosthetic linersocket interface during gait and assess patients' satisfaction with two different liners. Two prostheses with seal-in and locking liners were fabricated for each of the 10 subjects with transtibial amputation. The Vicon motion system was used to measure the pistoning during gait. The subjects were also asked to complete a Prosthesis Evaluation Questionnaire. The results revealed higher pistoning inside the socket during gait with the locking liner than with the seal-in liner (p < 0.05). The overall satisfaction with the locking liner was higher (p < 0.05) because of the relative ease with which the patients could don and doff the device. As such, pistoning may not be the main factor that determines patients' overall satisfaction with the prosthesis and other factors may also contribute to comfort and satisfaction with prostheses. The article also verifies the feasibility of the Vicon motion system for measuring pistoning during gait.

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“…In contrast, with over 8000 steps taken daily by transtibial amputees [52], the residuum often experiences dynamic, cyclic loading. During gait, complex internal stresses and strains develop: weight bearing causes pressure at the socket-limb interface [53]; the vertical pistoning movement between the residuum and the socket invokes shear forces [54]; and gait action and bone movement lead to the development of additional forces and moments [55,56]. The combination of these forces and moments results in internal compressive, tensile, and shear stress [57].…”

Section: Loading Biomechanics and Direct Deformationmentioning

confidence: 99%

Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review

2020

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Background: The soft tissue of the residual limb in transtibial prosthetic users encounters unique biomechanical challenges. Although not intended to tolerate high loads and deformation, it becomes a weight-bearing structure within the residuum-prosthesis-complex. Consequently, deep soft tissue layers may be damaged, resulting in Deep Tissue Injury (DTI). Whilst considerable effort has gone into DTI research on immobilised individuals, only little is known about the aetiology and population-specific risk factors in amputees. This scoping review maps out and critically appraises existing research on DTI in lower-limb prosthetic users according to (1) the population-specific aetiology, (2) risk factors, and (3) methodologies to investigate both. Results: A systematic search within the databases Pubmed, Ovid Excerpta Medica, and Scopus identified 16 English-language studies. The results indicate that prosthetic users may be at risk for DTI during various loading scenarios. This is influenced by individual surgical, morphological, and physiological determinants, as well as the choice of prosthetic componentry. However, methodological limitations, high inter-patient variability, and small sample sizes complicate the interpretation of outcome measures. Additionally, fundamental research on cell and tissue reactions to dynamic loading and on prosthesis-induced alterations of the vascular and lymphatic supply is missing. Conclusion: We therefore recommend increased interdisciplinary research endeavours with a focus on prosthesisrelated experimental design to widen our understanding of DTI. The results have the potential to initiate muchneeded clinical advances in surgical and prosthetic practice and inform future pressure ulcer classifications and guidelines.

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Assessment of amputee socket–stump–residual bone kinematics during strenuous activities using Dynamic Roentgen Stereogrammetric Analysis

Cited by 47 publications

References 27 publications

Marker-based method to measure movement between the residual limb and a transtibial prosthetic socket

Marker-based method to measure movement between the residual limb and a transtibial prosthetic socket

Transtibial prosthetic suspension: Less pistoning versus easy donning and doffing

Exploring the role of transtibial prosthetic use in deep tissue injury development: a scoping review

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