Comparison of muscle activity patterns of transfemoral amputees and control subjects during walking

Wentink, E.C.; Prinsen, Erik C.; Rietman, Johan Swanik; Veltink, Petrus H.

doi:10.1186/1743-0003-10-87

Cited by 76 publications

(65 citation statements)

References 23 publications

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“…It is well known that the symmetry in spatio-temporal, kinematic and kinetic parameters during gait is reduced in SP users compared to able-bodied persons [10–12]. In addition socket fitting problems [13], decreased hip abductor strength [13–15] and changed muscle activity patterns [16] may be a possible cause for this asymmetry. Gait asymmetry, specifically in the coronal [17–19] and sagittal plane [18], are considered to be associated with secondary complaints such as back pain [20].…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol

Leijendekkers

Staal

Hinte

et al. 2016

BMC Musculoskelet Disord

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BackgroundPatients with lower extremity amputation frequently suffer from socket-related problems. This seriously limits prosthesis use, level of activity and health-related quality of life (HRQoL). An additional problem in patients with lower extremity amputation are asymmetries in gait kinematics possibly accounting for back pain. Bone-anchored prostheses (BAPs) are a possible solution for socket-related problems. Knowledge concerning the level of function, activity and HRQoL after surgery is limited.The aims of this ongoing study are to: a) describe changes in the level of function, activity, HRQoL and satisfaction over time compared to baseline before surgery; b) examine potential predictors for changes in kinematics, prosthetic use, walking ability, HRQoL, prosthesis comfort over time and level of stump pain at follow-up; c) examine potential mechanisms for change of back pain over time by identifying determinants, moderators and mediators.Methods/designA prospective 5-year longitudinal study with multiple follow-ups. All adults, between May 2014 and May 2018, with lower extremity amputation receiving a press-fit BAP are enrolled consecutively. Patients with socket-related problems and trauma, tumour resection or stable vascular disease as cause of primary amputation will be included. Exclusion criteria are severe cognitive or psychiatric disorders. Follow-ups are planned at six-months, one-, two- and five-years after BAP surgery. The main study outcomes follow, in part, the ICF classification: a) level of function defined as kinematics in coronal plane, hip abductor strength, prosthetic use, back pain and stump pain; b) level of activity defined as mobility level and walking ability; c) HRQoL; d) satisfaction defined as prosthesis comfort and global perceived effect. Changes over time for the continuous outcomes and the dichotomized outcome (back pain) will be analysed using generalised estimating equations (GEE). Multivariate GEE will be used to identify potential predictors for change of coronal plane kinematics, prosthetic use, walking ability, HRQoL, prosthesis comfort and for the level of post-operative stump pain. Finally, potential mechanisms for change in back pain frequency will be explored using coronal plane kinematics as a potential determinant, stump pain as moderator and hip abductor strength as mediator.DiscussionThis study may identify predictors for clinically relevant outcome measures.Trial registration NTR5776. Registered 11 March 2016, retrospectively registered.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-016-1341-z) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol

Leijendekkers

Staal

Hinte

et al. 2016

BMC Musculoskelet Disord

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“…Gait analysis uses a number of research methods: kinematics (Branco, Santos-Rocha, Aguiar, Vieira, & Veloso, 2013), kinetics (Kim & Lee, 2013), EMG (Wentink, Prinsen, Rietman, & Veltink, 2013), and various other methods employing devices such as accelerometers, gyroscopes, and magnetoresistive sensors (Paquet, Auvinet, Chaleil, & Barrey, 2003;Tao, Liu, Zheng, & Feng, 2012). Combinations of different methods are frequently employed (Gross et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

System of gait analysis based on ground reaction force assessment

Vaverka¹,

Elfmark²,

Svoboda³

et al. 2015

Acta Gymnica

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Background: Biomechanical analysis of gait employs various methods used in kinematic and kinetic analysis, EMG, and others. One of the most frequently used methods is kinetic analysis based on the assessment of the ground reaction forces (GRF) recorded on two force plates. Objective: The aim of the study was to present a method of gait analysis based on the assessment of the GRF recorded during the stance phase of two steps. Methods: The GRF recorded with a force plate on one leg during stance phase has three components acting in directions: Fx -mediolateral, Fy -anteroposterior, and Fz -vertical. A custom-written MATLAB script was used for gait analysis in this study. This software displays instantaneous force data for both legs as Fx(t), Fy(t) and Fz(t) curves, automatically determines the extremes of functions and sets the visual markers defining the individual points of interest. Positions of these markers can be easily adjusted by the rater, which may be necessary if the GRF has an atypical pattern. The analysis is fully automated and analyzing one trial takes only 1-2 minutes. Results: The method allows quantification of temporal variables of the extremes of the Fx(t), Fy(t), Fz(t) functions, durations of the braking and propulsive phase, duration of the double support phase, the magnitudes of reaction forces in extremes of measured functions, impulses of force, and indices of symmetry. The analysis results in a standardized set of 78 variables (temporal, force, indices of symmetry) which can serve as a basis for further research and diagnostics. Conclusions: The resulting set of variable offers a wide choice for selecting a specific group of variables with consideration to a particular research topic. The advantage of this method is the standardization of the GRF analysis, low time requirements allowing rapid analysis of a large number of trials in a short time, and comparability of the variables obtained during different research measurements.

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“…Recently however, studies have focussed on the kinetics and muscular activity of amputee gait to provide a more complete picture of the biomechanics of the limbs and trunk during amputee walking. Studies assessing the effect of different prosthetic components [6][7][8] and of amputation level [9][10][11][12][13][14] during amputee gait have led to consistent findings of reduced peak ankle plantar-flexion moment and power and increased peak hip power generation and absorption in amputees. This has led to several avenues of research, particularly the design and development of active (powered) prosthetic limbs [15][16][17].…”

mentioning

confidence: 91%

Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off

Weinert-Aplin

Howard

Twiste

et al. 2017

Medical Engineering & Physics

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Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking. Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments. At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12W/kg vs. 1.05W/kg for intact limbs and 0.97W/kg vs. 0.99W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12W/kg vs. 0.87W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip. This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.

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Comparison of muscle activity patterns of transfemoral amputees and control subjects during walking

Cited by 76 publications

References 23 publications

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol

System of gait analysis based on ground reaction force assessment

Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off

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