Asymmetrical loading demands associated with vertical jump landings in people with unilateral transtibial amputation

Schoeman, Marlene; Diss, Ceri; Strike, Siobhán

doi:10.1682/jrrd.2012.10.0199

Cited by 9 publications

(2 citation statements)

References 39 publications

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“…To analyze the amount of asymmetry between the dominant and non-dominant lower limbs, we used the absolute symmetry index (ASI) and the symmetry index (SI) [31–34]. The equations for the SI and ASI of muscle i are: …”

Section: Methodsmentioning

confidence: 99%

Symmetry and spatial distribution of muscle glucose uptake in the lower limbs during walking measured using FDG-PET

Kolk¹,

Klawer²,

Visser

et al. 2019

PLoS ONE

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Purpose This study aimed to elucidate whether muscle activity (in terms of glucose uptake) between the legs can be considered symmetrical during walking. Furthermore, we aimed to determine whether the [ 18 F]-fluorodeoxyglucose was distributed heterogeneously throughout each muscle, and if so, whether areas of high uptake would be clustered. Methods Ten healthy participants walked on a treadmill at self-selected comfortable walking speed for a total of 90 minutes, 60 minutes before and 30 minutes after intravenous injection of 50 MBq [ 18 F]-fluorodeoxyglucose. Thereafter, a positron emission tomography/computed tomography scan of the lower limb was acquired. Three-dimensional muscle contours of 78 (= 39x2) muscles of the left and right lower limb were semi-automatically determined from magnetic resonance imaging scans. After non-rigid registration, those muscle contours were used to extract [ 18 F]-fluorodeoxyglucose uptake from the positron emission tomography scans. Results Large asymmetries were observed in the lower leg muscles (e.g. median absolute asymmetry index of 42% in the gastrocnemius medialis) and in the gluteus minimus (30% asymmetry) and gluteus medius (15% asymmetry), whereas the uptake in the thighs was relatively symmetrical between the limbs (<6% asymmetry). These were not related to limb-dominance nor to inter-limb differences in muscle volume. The [ 18 F]-fluorodeoxyglucose distribution was not distributed normally; most voxels had a relatively low standardized uptake value, and a minority of voxels had a relatively high standardized uptake value. The voxels with higher [ 18 F]-fluorodeoxyglucose uptake were distributed heterogeneously; they were clustered in virtually all muscles. Conclusion The findings in this study challenge the common assumption of symmetry in muscle activity between the limbs in healthy subjects. The clustering of voxels with high uptake suggests that even in this prolonged repetitive task, different spatial regions of muscles contribute differently to walking than others.

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Section: Methodsmentioning

confidence: 99%

Symmetry and spatial distribution of muscle glucose uptake in the lower limbs during walking measured using FDG-PET

Kolk¹,

Klawer²,

Visser

et al. 2019

PLoS ONE

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show abstract

“…The electrical control system comprised the sensor subsystem, the microcontroller subsystem and the actuator subsystem. The sensor subsystem was composed of a strain gauge bridge sensor, an angle sensor, a motor encoder and a switcher (details can refer beneficial to avoid excessive loading onto one or the other limb Melzer et al (2001); Schoeman et al (2013). Gait asymmetry also contributes to function disability, and therefore improving gait symmetry to avoid the potential risk of illness is a challenge Patterson et al (2010).…”

Section: Prosthesis Prototypementioning

confidence: 99%

Gait-Symmetry-Based Human-in-the-Loop Optimization for Unilateral Transtibial Amputees With Robotic Prostheses

Feng

Mao

Zhang

et al. 2022

IEEE Trans. Med. Robot. Bionics

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Gait asymmetry due to the loss of unilateral limb increases the risk of injury or progressive joint degeneration. The development of wearable robotic devices paves a way to improve gait symmetry of unilateral amputees. Moreover, the state-of-the-art studies on human-in-the-loop optimization strategies through decreasing the metabolic cost as the optimization task, have met several challenges, e.g. too long period of optimization and the optimization feasibility for unilateral amputees who have the deficit of gait symmetry. Here, in this paper, we proposed gait-symmetry-based human-in-the-loop optimization method to decrease the risk of injury or progressive joint degeneration for unilateral transtibial amputees. The experimental results (N = 3 unilateral transtibial subjects) demonstrate that only average 9.0±4.1min of convergence was taken. Compared to gait symmetry while wearing prosthetics, after optimization, the gait symmetry indicator value of the subjects wearing the robotic prostheses was improved by 21.0% and meanwhile the net metabolic energy consumption value was reduced by 9.2%. Also, this paper explores the rationality of gait indicators and what kind of gait indicators are the optimization target. These results suggest that gait-symmetry-based human-in-the-loop strategy could pave a practical way to improve gait symmetry by accompanying the reduction of metabolic cost, and thus to decrease the risk of joint injury for the unilateral amputees. KeywordsHuman-in-the-loop, gait symmetry, metabolic cost, unilateral transtibial amputees, robotic prostheses metabolic cost rate. Moreover, few studies of human-inthe-loop focused on the unilateral amputees, who had the consequences of gait symmetry.Biological studies show that due to the loss of lower limb, the amputees exhibited the gait asymmetry in kinetics and kinematics, compared to the able-bodied Sanderson and Martin (1997). For the unilateral amputees, this kind of gait asymmetry influences the maximum torque and torque steadiness significantly in the intact leg in some extents Simoneau-Buessinger et al. (2019). The reason for gait asymmetry maybe mainly resulted from strength asymmetry Lloyd et al. (2010), during walking. Strength asymmetry in unilateral transtibial amputees has a moderate relationship in an increased risk of developing osteoarthritis Lloyd et al. (2010). For the transtibial amputees, the walking speed also influenced gait symmetry Nolan et al. (2003). During jumping landing, peak force asymmetry and moment asymmetry may potentially be easy to result in injury or progressive joint degeneration for transtibial amputees and improving gait symmetry in jumping is

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Dynamic elastic response prostheses alter approach angles and ground reaction forces but not leg stiffness during a start-stop task

Haber

Ritchie

Strike

2018

Human Movement Science

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In a dynamic elastic response prosthesis (DERP), spring-like properties aim to replace the loss of musculature and soft tissues and optimise dynamic movement biomechanics, yet higher intact limb (IL) loading exists. It is unknown how amputees wearing a DERP will perform in start-stop movements and how altering the prosthetic stiffness will influence the performance and loading. This study assessed movement dynamics through comparisons in spatiotemporal, kinematic and kinetic variables and leg stiffness of intact, prosthetic and control limbs. The effect of prosthetic stiffness on movement dynamics was also determined. Eleven male unilateral transtibial amputees performed a start-stop task with one DERP set at two different stiffness - Prescribed and Stiffer. Eleven control participants performed the movement with the dominant limb. Kinematic and kinetic data were collected by a twelve-camera motion capture system synchronised with a Kistler force platform. Selected variables were compared between intact, prosthetic and control limbs, and against prosthetic stiffness using ANOVA and effect size. Pearson's Correlation was used to analyse relationship between leg stiffness and prosthetic deflection. Amputees showed a more horizontal approach to the bound during the start-stop movement, with lower horizontal velocities and a longer stance time on the IL compared to controls. In both stiffness conditions, the IL showed selected higher anteroposterior and vertical forces and impulses when compared to the controls. Leg stiffness was not significantly different between limbs as a result of the interplay between angle swept and magnitude of force, even with the change in prosthetic stiffness. A main effect for prosthetic stiffness was found only in higher impact forces of the prosthetic limb and more horizontal touchdown angles of the IL when using the prescribed DERP. In conclusion, amputees achieve the movement with a horizontal approach when compared to controls which may reflect difficulty of movement initiation with a DERP and a difficulty in performing the movement dynamically. The forces and impulses of the IL were high compared to control limbs. The consistent leg stiffness implies compensation strategies through other joints.

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Asymmetrical loading demands associated with vertical jump landings in people with unilateral transtibial amputation

Cited by 9 publications

References 39 publications

Symmetry and spatial distribution of muscle glucose uptake in the lower limbs during walking measured using FDG-PET

Symmetry and spatial distribution of muscle glucose uptake in the lower limbs during walking measured using FDG-PET

Gait-Symmetry-Based Human-in-the-Loop Optimization for Unilateral Transtibial Amputees With Robotic Prostheses

Dynamic elastic response prostheses alter approach angles and ground reaction forces but not leg stiffness during a start-stop task

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