Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review

Sagawa, Yoshimasa; Turcot, Katia; Armand, Stéphane; Thévenon, A.; Vuillerme, Nicolas; Watelain, Éric

doi:10.1016/j.gaitpost.2011.02.003

Cited by 201 publications

(167 citation statements)

References 99 publications

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“…Initially, it would seem unlikely that the motion about the prosthetic ankle would be strongly related to prosthetic preference given the historical perspective that the performance of the five remaining biological joints are strongly affected and need to compensate [38][39][40][41][42][43]. However, these studies largely focus on energy generation and absorption.…”

Section: Discussionmentioning

confidence: 99%

Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle

Wurdeman

Myers

Jacobsen³

et al. 2013

JRRD

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Abstract-The purpose of this study was to determine the relationship between stride-to-stride fluctuations and prosthesis preference. Thirteen individuals with unilateral, transtibial amputation consented to participate. Individuals walked on a treadmill for 3 min with their prescribed and an alternate prosthesis. Stride-to-stride fluctuations were quantified with the largest Lyapunov exponent (LyE) of each joint flexion/extension time series. The change in the LyE was calculated for each major lower-limb joint for both conditions. Participants indicated preference between the prostheses on a continuous visual analog scale. The change in the LyE was correlated with the degree of preference between the two prostheses at the prosthetic ankle. The change in the LyE of the prosthetic ankle was strongly related to the degree of preference (r = 0.629, p = 0.02). Thus, stride-to-stride fluctuations, quantified by the LyE, are strongly related to the patient's perception of the prosthesis. As a result, the LyE is the first objective measure to detect changes in gait that relate to the patient's perception of the prosthesis. The LyE should be further examined as a potentially effective prescriptive and outcome measure in prosthetic rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle

Wurdeman

Myers

Jacobsen³

et al. 2013

JRRD

View full text Add to dashboard Cite

show abstract

“…Functional evaluations are also used to give global scores based on self-reported questionnaires such as the Prosthetic Profile Amputee-Locomotor Capacities Index (PPA-LCI) and the 36-Item Short Form Health Survey (SF-36) or on performance measures such as the 6-minute walk test (6MWT) [2]. Finally, quantitative analysis of gait provides detailed biomechanical parameters useful to the understanding of gait limitations [3]. Most often, these parameters (muscular, functional, and biomechanical) are studied independently.…”

Section: Introductionmentioning

confidence: 99%

Influence of physical capacities of males with transtibial amputation on gait adjustments on sloped surfaces

Langlois

Villa

Bonnet³

et al. 2014

J Rehabil Res Dev

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Abstract-The aim of the study was to investigate how kinematic and kinetic adjustments between level and slope locomotion of persons with transtibial amputation are related to their individual muscular and functional capacities. A quantified gait analysis was conducted on flat and slope surfaces for seven patients with transtibial amputation and a control group of eight subjects to obtain biomechanical parameters. In addition, maximal isometric muscular strength (knee and hip extensors) and functional scores were measured. The results of this study showed that most of the persons with transtibial amputation could adapt to ramp ascent either by increasing ankle, knee, and hip flexion angles of the residual limb and/or by recruiting their hip extensors to guarantee enough hip extension power during early stance. Besides, 6-minute walk test score was shown to be a good predictor of adaptation capacities to slope ascent. In ramp descent, the increase of knee flexion moment was correlated with knee extensor strength and residual-limb length. However, no correlation was observed with functional parameters. Results show that the walking strategy adopted by persons with transtibial amputation to negotiate ramp locomotion mainly depends on their muscular capacities. Therefore, muscular strengthening should be a priority during rehabilitation.

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“…Altered and asymmetric gait among persons with lower-limb amputations, which are commonly observed during unloaded walking [13], may further degrade in response to load carriage. Intact limbs can respond to changes in external demands by altering the activity of muscles crossing the joint.…”

Section: Introductionmentioning

confidence: 99%

Kinematic analysis of males with transtibial amputation carrying military loads

Schnall

Hendershot

Bell³

et al. 2014

J Rehabil Res Dev

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Abstract-The biomechanical responses to load carriage, a common task for dismounted troops, have been well studied in nondisabled individuals. However, with recent shifts in the rehabilitation and retention process of injured servicemembers, there remains a substantial need for understanding these responses in persons with lower-limb amputations. Temporalspatial and kinematic gait parameters were analyzed among 10 male servicemembers with unilateral transtibial amputation (TTA) and 10 uninjured male controls. Participants completed six treadmill walking trials in all combinations of two speeds (1.34 and 1.52 m/s) and three loads (none, 21.8, and 32.7 kg). Persons with TTA exhibited biomechanical compensations to carried loads that are comparable to those observed in uninjured individuals. However, several distinct gait changes appear to be unique to those with TTA, notably, increased dorsiflexion (deformation) of the prosthetic foot/ankle, less stance knee flexion on the prosthetic limb, and altered trunk forward lean/excursion. Such evidence supports the need for future work to assess the risk for overuse injuries with carried loads in this population in addition to guiding the development of adaptive prosthetic feet/components to meet the needs of redeployed servicemembers or veterans/civilians in physically demanding occupations.

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Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review

Cited by 201 publications

References 99 publications

Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle

Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle

Influence of physical capacities of males with transtibial amputation on gait adjustments on sloped surfaces

Kinematic analysis of males with transtibial amputation carrying military loads

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