Estimation of the forces generated by the thigh muscles for transtibial amputee gait

Voinescu, Mihai; Soares, Denise Paschoal; Jorge, R.M. Natal; Davidescu, Arjana; Machado, Leandro

doi:10.1016/j.jbiomech.2012.01.010

Cited by 9 publications

(5 citation statements)

References 18 publications

(24 reference statements)

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“…14,15 The lower limb amputees (both transfemoral and TT) were found to rely on their sound limb more than the amputated limb during everyday activities including STS task due to impairments which some of them mentioned above. 9,[16][17][18][19][20][21][22][23] In a recent review of the literature, Gailey et al 20 have reported that asymmetrical loading of body weight distribution may lead to secondary physical impairments such as osteoarthritis and osteoporosis in this population. One of the important focuses of amputee rehabilitation should be avoiding the non-amputated limb from the secondary musculoskeletal impairments in the scope of preventive rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

Özyürek

Demırbüken

Angin

2014

Prosthetics &Amp; Orthotics International

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Section: Introductionmentioning

confidence: 99%

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

Özyürek

Demırbüken

Angin

2014

Prosthetics &Amp; Orthotics International

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“…9 However, the muscle use patterns in BKA prosthetic ambulation are different than that of a normal leg, with vastus lateralis forces roughly double those of the nonamputee. 10 These altered biomechanics could potentially be expected to magnify the ALT's otherwise benign donor-site morbidity. We chose to harvest the ALT flap from the injured leg to avoid any morbidity in the uninjured leg.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of a Below-the-Knee Amputation Stump in the Setting of Popliteal Transection: Supercharging an Anterolateral Thigh Free Flap for Vein Graft Coverage

Skovgaard

Deleyiannis

2016

J Reconstr Microsurg Open

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Amputation height in the lower extremity influences a patient's likelihood of achieving ambulation, ability to use a prosthetic device, energy expenditure while walking, and overall quality of life, with a below-the-knee amputation (BKA) being superior to an above-the-knee amputation (AKA) in all these regards. 1,2 Salvage of a threatened BKA should be attempted rather than conversion to AKA when possible. Here, we present a patient with a BKA wound breakdown whose reconstruction was made challenging by transection of the popliteal artery. In this context, we present the first case of a supercharged/venous augmented anterolateral thigh (ALT) free flap used for BKA stump reconstruction. Case PresentationA 25-year-old man with a BKA performed after a gunshot wound to the knee presented with extensive wound breakdown and 12 cm of residual tibia (►Fig. 1). Primary closure would have required excessive tibial shortening, so free tissue transfer was planned. An angiogram revealed the popliteal artery ending 6 cm above the joint line. The descending geniculate artery was intact.For recipient vessels, the superficial femoral artery (SFA) and superficial femoral vein (SFV) as well as the descending geniculate vessels were exposed at the anterior margin of the adductor hiatus. The ALT flap was marked on the ipsilateral thigh and measured 32 by 8 cm (matching the size of the defect). During harvest, an unusual pedicle was encountered as described by Tamimy and O'Boyle. 3 It arose from the proximal SFA/SFV, coursed medial and then anterior to the rectus femoris, supplying the upper half of our proposed flap. The perforators from the descending branch of the lateral femoral circumflex artery (DLFC) were then dissected back to the profunda femoral artery. The superior half of the flap was supplied by the SFA, which is more typical of the blood supply of the anteromedial thigh (AMT) flap, and the lower half by the DLFC. This large AMT/ALT free flap was then harvested with both pedicles (►Fig. 2). The AMT pedicle was anastomosed to the descending geniculate vessels. Two 15-cm saphenous interposition grafts were required to connect the DLFC pedicle to the SFA/SFV. The flap was inset and the donor site was closed primarily (►Fig. 3). DiscussionA tibial length of 15 cm is classically considered to be ideal, 4 with many considering 8 cm to be the minimum for optimal prosthetic fitting. 5 Using special fitting techniques, some AbstractWe present the first case of a super charged/venous augmented anterolateral thigh (ALT) free flap used for below-the-knee stump reconstruction. Due to medical knee tissue loss, tunneled vein grafts could have been at risk for exposure. The inclusion of a second pedicle allowed reliable soft tissue coverage of the vein grafts, while the ALT component of the flap covered the exposed tibia.

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“…After that, the individuals stepped on the automated treadmill to carry out the study (NordicTrack T12.2, Model NETL 12812.0, Icon (Health&Fitness, Logan, UT, USA) [ 17 ]. The participants walked for two minutes at each of the four speeds [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Muscle Activation during Gait in Unilateral Transtibial Amputee Patients with Prosthesis: The Influence of the Insole Material Density

Sarroca¹,

Luesma

Valero³

et al. 2021

JCM

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Background: Walking is a complex process that is highly automated and efficient. This knowledge is essential for the study of pathological gait. The amputation of lower limbs involves new biomechanical load and gait patterns, and injuries due to overload or disuse may occur. The objective of this study is to assess muscle activation as part of the gait in unilateral transtibial amputee patients with prosthesis, at different speeds and with different plantar supports. Method: Included in the sample were 25 people with amputation and 25 control participants. Muscle activation was evaluated in both groups by means of surface electromyography (EMG) under normal and altered conditions. Results: Control participants did not show statistically significant differences (p ˃ 0.05) between their muscle groups, irrespective of support and speed. However, people with amputation did show differences in muscle activity in the quadriceps, all of which occurred at the highest speeds, irrespective of support. In the analysis between groups, significant differences (p < 0.05) were obtained between the leg of the amputee patient and the leg of the control participant, all of them in the quadriceps, and at speeds 3 and 4, regardless of the insole used. Conclusions: Participants with unilateral transtibial amputation carry out more quadriceps muscle activity during gait compared to the control group.

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Estimation of the forces generated by the thigh muscles for transtibial amputee gait

Cited by 9 publications

References 18 publications

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

Altered movement strategies in sit-to-stand task in persons with transtibial amputation

Reconstruction of a Below-the-Knee Amputation Stump in the Setting of Popliteal Transection: Supercharging an Anterolateral Thigh Free Flap for Vein Graft Coverage

Muscle Activation during Gait in Unilateral Transtibial Amputee Patients with Prosthesis: The Influence of the Insole Material Density

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