Energy cost of walking in transfemoral amputees: Comparison between Marlo Anatomical Socket and Ischial Containment Socket

Traballesi, Marco; Delussu, Anna Sofia; Averna, T.; Pellegrini, Roberto; Paradisi, Francesco; Brunelli, Stefano

doi:10.1016/j.gaitpost.2011.05.012

Cited by 31 publications

(31 citation statements)

References 23 publications

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“…1,2 The quantification of metabolic energy cost, as an evaluation of the overall efficiency of gait, has been widely used to compare prosthetic elements. [3][4][5][6] However, the reference method of quantification, oxygen consumption, implies the measurement of exhaled gas and cannot always be easily integrated into conventional gait analysis.…”

Section: Introductionmentioning

confidence: 99%

Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity

Bonnet

Villa

Fodé

et al. 2013

Proc Inst Mech Eng H

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The greater metabolic demand during the gait of people with a transfemoral amputation limits their autonomy and walking velocity. Major modifications of the kinematic and kinetic patterns of transfemoral amputee gait quantified using gait analysis may explain their greater energy cost. Donelan et al. proposed a method called the individual limb method to explore the relationships between the gait biomechanics and metabolic cost. In the present study, we applied this method to quantify mechanical work performed by the affected and intact limbs of transfemoral amputees. We compared a cohort of six active unilateral transfemoral amputees to a control group of six asymptomatic subjects. Compared to the control group, we found that there was significantly less mechanical work produced by the affected leg and significantly more work performed by the unaffected leg during the step-to-step transition. We also found that this mechanical work increased with walking velocity; the increase was less pronounced for the affected leg and substantial for the unaffected leg. Finally, we observed that the lesser work produced by the affected leg was linked to the increase in the hip flexion moment during the late stance phase, which is necessary for initiating knee flexion in the affected leg. It is possible to quantify the mechanical work performed during gait by people with a transfemoral amputation, using the individual limb method and conventional gait laboratory equipment. The method provides information that is useful for prosthetic fitting and rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity

Bonnet

Villa

Fodé

et al. 2013

Proc Inst Mech Eng H

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“…In the ICS, support is further supplemented by hydrostatic weight-bearing as a result of the relatively smaller socket volume, and a narrow proximal medial-lateral socket dimension improves coronal plane stability. A variant of ICS introduced in the early 2000s is the Marlo Anatomical Socket (MAS), 21 which achieves coronal plane stability by containing only the ischial ramus and lowering other trim lines to allow greater range of hip motion. Another design, introduced in the last decade, is the High-Fidelity (Hi-Fi) socket, 22 which has struts that compress the soft tissues of the thigh to achieve femur stabilisation, allowing excess tissue to flow through openings between the struts.…”

Section: Prosthetic Socket Designs and Suspension Mechanisms Of The Lmentioning

confidence: 99%

Lower limb prosthetic interfaces

Safari

2020

Prosthetics &Amp; Orthotics International

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The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.

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“…In trans-femoral prosthetics, liner suspensions are only slowly becoming more prevalent, which is owed to the less readily accommodated properties of typical residual limbs, namely their length, shape, and tissue composition [96]. Nonetheless, remarkable improvements in terms of socket compliance, hip range of motion, appearance (damage to clothing), and muscle utilization have been achieved with modern socket designs and materials [97][98][99][100].…”

Section: Prosthetic Components and Fittingmentioning

confidence: 99%

Rehabilitation of People with Lower-Limb Amputations

Fiedler

Akins

Cooper

et al. 2014

Curr Phys Med Rehabil Rep

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Rehabilitation of persons with lower-limb amputation is a complex endeavor that requires the consideration of a multitude of factors. This article provides an overview of the current practice of prosthesis prescription, mobility training, and the utilization of wheeled mobility options in the clinical care for this population. Recent technological advancements have helped fit persons with lower-limb amputation with more functional, better fitting, and less activity-limiting artificial limbs and wheelchairs. This is exemplified in modern computer-controlled prosthetic components and biomechanically optimized socketfitting methods, as well as light weight and versatile wheelchairs to supplement or replace prosthetic devices. In the research setting, technology has enabled new approaches to the kinematic and kinetic assessment of prosthetic interventions, and the development of more accurate fitting and evaluation methods. Despite the noted progress in the field, there is still a considerable gap between the functionality of a sound leg and even the most advanced prosthesis. It can be predicted that continued research efforts will be undertaken to further close this gap.

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Energy cost of walking in transfemoral amputees: Comparison between Marlo Anatomical Socket and Ischial Containment Socket

Cited by 31 publications

References 23 publications

Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity

Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity

Lower limb prosthetic interfaces

Rehabilitation of People with Lower-Limb Amputations

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