Effects of Isometric Muscle Training on Residual Limb Volume, Strength, and Gait of Below-Knee Amputees

Kegel, B; Burgess, Ernest M.; Starr, Thomas W; Daly, Wayne

doi:10.1093/ptj/61.10.1419

Cited by 23 publications

(36 citation statements)

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“…Amputee gait has been evaluated both qualitatively (Gonzalez et al, 1974;Urban 1973; Waters et al, 1976; Kegel et al, 1981) and quantitatively in the literature. Quantitative fesearch can be further subdivided into kinematic and kinetic studies.…”

Section: Introductionmentioning

confidence: 99%

The role of the contralateral limb in below-knee amputee gait

Hurley

McKenney²,

Robinson³

et al. 1990

Prosthetics &Amp; Orthotics International

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Very little quantitative biomechanical research has been carried out evaluating issues relevant to prosthetic management. The literature available suggests that amputees may demonstrate an asymmetrical gait pattern. Furthermore, studies suggest that the forces occurring during amputee gait may be unequally distributed between the contralateral and prosthetic lower limbs/This study investigates the role of the contralateral limb in amputee gait by determining lower limb joint reaction forces and symmetry of motion in an amputee and non-amputee population. Seven adult below-knee amputees and four non-amputees participated in the study. Testing involved collection of kinematic coordinate data employing a WATSMART video system and ground reaction force data using a Kistler force plate. The degree of lower limb symmetry was determined using bilateral angle-angle diagrams and a chain encoding technique. Ankle, knee and hip joint reaction forces were estimated in order to evaluate the forces acting across the joints of the amputee's contralateral limb. The amputees demonstrated a lesser degree of lower limb symmetry than the non-amputees. This asymmetrical movement was attributed to the inherent variability of the actions of the prosthetic lower limb. The forces acting across the joints of the contralateral limb were not significantly higher than that of the non-amputee. This suggests that, providing the adult amputee has a good prosthetic fit, there will not be increased forces across the joints of the contralateral limb and consequently no predisposition for the long-term wearer to develop premature degenerative arthritis.

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Section: Introductionmentioning

confidence: 99%

The role of the contralateral limb in below-knee amputee gait

Hurley

McKenney²,

Robinson³

et al. 1990

Prosthetics &Amp; Orthotics International

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show abstract

“…Compared with other domains of physical rehabilitation [16][17], the field of prosthetics has paid little attention to the translation of well-established motor learning strategies [18][19][20]. Instead, physical rehabilitation for individuals with lower limb loss has traditionally focused on what tasks to practice [21][22][23][24] and which strength and conditioning exercises to perform [25][26][27][28][29], rather than on how motor learning principles should be applied to the structure and organization of practice in order to most efficiently and effectively learn those tasks. The current state of prosthetic research also reflects this priority.…”

Section: Introductionmentioning

confidence: 99%

Beyond componentry: How principles of motor learning can enhance locomotor rehabilitation of individuals with lower limb loss--A review

Sawers

Hahn

Kelly

et al. 2012

JRRD

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Abstract-Relatively little attention has been given to the use of well-established motor learning strategies to enable individuals with lower limb loss to effectively and safely learn to walk with their prostheses in the home and community. Traditionally, such outcomes have been pursued by focusing on the design and function of a patient's prosthesis, rather than on how he or she should learn to use it. The use of motor learning strategies may enhance physical rehabilitation outcomes among individuals with lower limb loss. This review explores these motor learning strategies and ways in which they can be applied to the physical rehabilitation of individuals with lower limb loss and highlights some of the challenges to their implementation, as well as unanswered research questions.

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“…However, this control depends on the function of the muscles in the trans-tibia1 stump and the patient's ability to activate and control them. Kegel et al (1981) have shown that exercise of the stump musculature should be a part of routine physical therapy. The amputees must be able to control fully the musculature during gait.…”

Section: Introductionmentioning

confidence: 99%

Morphological changes during early trans-tibial prosthetic fitting

Lilja

Hoffmann²,

Öberg³

1998

Prosthetics &Amp; Orthotics International

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Morphological changes in the amputation stump may have serious implications regarding the suspension and fit of the prosthetic socket. In an earlier study (Lilja and Öberg, 1997) the authors have shown that the volume of the transtibial amputation stump decreases according to a negative power function after amputation, and that the stump volume does not stabilise until four months after the operation. In the present study, Magnetic Resonance Imaging (MRI) technique was used to examine morphological changes in the amputation stump after transtibial amputation in a small number of cases. The authors expected to find a decrease in the cross-sectional area of the stump and of the separate muscles similar to the findings in earlier studies. However, two different patterns were found. The cross-sectional area of the entire stump as well as that of the medial muscle group changed according to the authors' hypothesis, i.e. an initial fast decrease, followed by a more moderate decrease of the area. In the lateral muscle group another pattern was found. After an initial rapid decrease the area increased, sometimes to a magnitude larger than the initial value. After the amputation the lateral muscle group may acquire a new function, contributing to the suspension of the socket. Despite the limited number of patients, this study presents findings which may be important in the clinical fitting of trans-tibial prostheses.

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Effects of Isometric Muscle Training on Residual Limb Volume, Strength, and Gait of Below-Knee Amputees

Cited by 23 publications

References 0 publications

The role of the contralateral limb in below-knee amputee gait

The role of the contralateral limb in below-knee amputee gait

Beyond componentry: How principles of motor learning can enhance locomotor rehabilitation of individuals with lower limb loss--A review

Morphological changes during early trans-tibial prosthetic fitting

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