Compensatory mechanism involving the knee joint of the intact limb during gait in unilateral below-knee amputees

Beyaert, C.; Grumillier, C.; Martinet, N.; Paysant, Jean; André, J. M.

doi:10.1016/j.gaitpost.2007.12.073

Cited by 76 publications

(108 citation statements)

References 19 publications

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“…We expected that biomechanical variables associated with arthritis such as peak, rate, and duration of loading would be greater in intact limbs of all subjects with unilateral limb loss as compared with control subjects. Previous studies found larger peak vertical ground reaction forces in the intact limb of individuals with unilateral transtibial and transfemoral limb loss compared with control subjects [2,22]. Similar increases were not found in those with unilateral limb loss in this study, which may be influenced by the longer mean time since limb loss for the subjects evaluated in previous studies.…”

Section: Discussionsupporting

confidence: 69%

See 1 more Smart Citation

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Pruziner

Werner

Copple

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The initiation and progression of knee and hip arthritis have been related to limb loading during ambulation. Although altered gait mechanics with unilateral lower limb loss often result in larger and more prolonged forces through the intact limb, how these forces differ with traumatic limb loss and duration of ambulation have not been well described.Questions/purposes The purpose of this study was to determine whether biomechanical variables of joint and limb loading (external adduction moments, vertical ground reaction force loading rates, and impulses) are larger in the intact limb of servicemembers with versus without unilateral lower limb loss and whether intact limb loading differs between shorter (B 6 months) versus longer (C 2 years) durations of ambulation with a prosthesis. 4.45-16.79; 10.18-12.81] 4.64-14.47; 8.26-9.74 82-19.51; 12.98-15.05]; ES = 0.43; p = 0.001), respectively. Intact limb mean and peak vertical ground reaction force loading rates were also larger in subjects with transfemoral limb loss with B 6 months and C 2 years of experience ambulating with a prosthesis versus control subjects .68] versus 9.03 BW/s [4.64-14.47; 8.26-9.74]; ES C 0.53; p \ 0.001;.05]; ES C 0.68; p \ 0.001, respectively). Similarly, intact limb vertical ground reaction force impulses ; ES C 0.53, p \ 0.001) were also larger among both groups of transfemoral subjects versus control subjects, respectively. Limb loading variables were not statistically different between times ambulating with a prosthesis within groups with transtibial or transfemoral limb loss. Conclusions Larger intact limb loading in individuals with traumatic transtibial loss were only noted early in the rehabilitation process, but these variables were present early and late in the rehabilitation process for those with transfemoral limb loss. Such evidence suggests an increased risk for early onset and progression of arthritis in the intact limb, especially in those with transfemoral limb loss. Clinical Relevance Interventions should focus on correcting modifiable gait mechanics associated with arthritis, particularly among individuals with transfemoral limb loss, to potentially mitigate the development and progression in this population.versus 9.03 BW/s [

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Section: Discussionsupporting

confidence: 69%

“…Persons with lower limb loss develop knee/hip arthritis at an earlier age than the general population [2,12,14]. However, preventing the onset and progression of this disease is difficult because the mechanisms of the development of arthritis are still largely unknown [1,29].…”

Section: Discussionmentioning

confidence: 99%

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Pruziner

Werner

Copple

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Another common movement strategy observed in this population is increased hip extension (p > 0.05) during stance phase of the amputated limb. This compensatory strategy is reasoned as a protective strategy to minimize the loading of the amputated limb and as a compensation of weak knee extensor muscles [6,10,41]. Studies have shown decreased knee muscle strength in the amputated limb as compared with the intact limb in persons with TTA [52].…”

Section: Hip Kinematics During Walking In Persons With Lowerlimb Ampumentioning

confidence: 99%

“…Such compensatory movements are asymmetric in nature, with either increased or decreased motion occurring in the joints of the amputated limb as compared with the intact limb and/or referent limb of nondisabled controls [3,5,9]. The terms "movement adaptations" [3,6], "compensatory movements" [10][11], and "asymmetrical movements" [5,9] are often used interchangeably in the amputation literature. While movement asymmetries are a form of adaptation following lower-limb amputation, the potential exists that some of the lumbopelvic and lower-limb movement asymmetries could be "maladaptive," potentially predisposing this population to musculoskeletal disorders such as low back pain (LBP) and osteoarthritis [12][13].…”

Section: Introductionmentioning

confidence: 99%

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

et al. 2015

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Abstract-Following amputation, people with transfemoral amputation (TFA) and transtibial amputation (TTA) adapt with asymmetrical movements in the spinal and lower-limb joints. The aim of this review is to describe the trunk, lumbopelvic, and hip joint movement asymmetries of the amputated limb of people with TFA and TTA during functional tasks as compared with the intact leg and/or referent leg of nondisabled controls. Electronic databases were searched from inception to February 2014. Studies with kinematic data comparing (1) amputated and intact leg and (2) amputated and referent leg of nondisabled controls were included (26 articles). Considerable heterogeneity in the studies precluded data pooling. During stance phase of walking in participants with TFA, there is moderate evidence for increased trunk lateral flexion toward the amputated limb as compared with the intact leg and increased anterior pelvic tilt as compared with nondisabled controls. None of the studies investigated spinal kinematics during other functional tasks such as running, ramp walking, stair climbing, or obstacle crossing in participants with TFA or TTA. Overall, persons with TFA adapt with trunk and pelvic movement asymmetries at the amputated limb to facilitate weight transfer during walking. Among participants with TTA, there is limited evidence of spinal and pelvic asymmetries during walking.

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“…But alignment changes influence the walking pattern of prosthesis users. For example, results of studies indicate that the ground reaction forces are sensitive to alignment changes [4][5][6][7], also influencing, among others, the contralateral, nondisabled limb as reflected in an increased maximal knee flexion angle and work load at the knee joint [8]. Thus, changing shoes with different HHs, even within the category of "flat heels," has an effect on the function of the prosthesis and the wearer's comfort.…”

Section: Introductionmentioning

confidence: 99%

Development of inexpensive prosthetic feet for high-heeled shoes using simple shoe insole model

2014

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Abstract-The large majority of prosthetic feet are aimed at low-heeled shoes, with a few models allowing a heel height of up to 5 cm. However, a survey by the American Podiatric Medical Association indicates that most women wear heels over 5 cm; thus, current prosthetic feet limit most female prosthesis users in their choice. Some prosthetic foot components are heel-height adjustable; however, their plantar surface shapes do not change to match the insole shapes of the shoes with different heel heights. The aims of the study were therefore (1) to develop a model that allows prediction of insole shape for various heel height shoes in combination with different shoe sizes and (2) to develop and field-test low-cost prototypes of prosthetic feet whose insole shapes were based on the new model. An equation was developed to calculate insole shapes independent of shoe size. Field testing of prototype prosthetic feet fabricated based on the equation was successful and demonstrated the utility of the equation.

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Compensatory mechanism involving the knee joint of the intact limb during gait in unilateral below-knee amputees

Cited by 76 publications

References 19 publications

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

Development of inexpensive prosthetic feet for high-heeled shoes using simple shoe insole model

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