Evolution of vaulting strategy during locomotion of individuals with transfemoral amputation on slopes and cross-slopes compared to level walking

Villa, Coralie; Drevelle, Xavier; Bonnet, Xavier; Lavaste, F.; Loiret, Isabelle; Fodé, Pascale; Pillet, Hélène

doi:10.1016/j.clinbiomech.2015.03.022

Cited by 20 publications

(15 citation statements)

References 17 publications

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“…Furthermore, they concluded that vF 2 values of an amputated limb decreased along with an increase of gait velocity. Lower vGRF values in the intact limb in the final support phase could occur as an adaptive mechanism to increase the foot clearance of the prosthetic foot, otherwise also known as the vaulting [ 13 ]. The results obtained in this research, when compared with those obtained by different authors, showed that vF 1 , vF 3 , and a-pF 1 GRF of the intact limb were identical for healthy people, while the values for the amputated limbs were much smaller [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

Rutkowska-Kucharska

Kowal

Winiarski

2018

Applied Bionics and Biomechanics

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Many studies have shown that unilateral transfemoral amputation involves asymmetric gait. Transfemoral amputation leads to muscle atrophy in a tight stump resulting in asymmetry in muscle torque between the amputated and intact limb. This research is aimed at verifying if a relationship between torque values of hip joint flexors and extensors and gait asymmetry in patients with TFA exists. Fourteen adult subjects with unilateral TFA took part in the experiment. Gait symmetry was evaluated based on the ground reaction force (GRF). Measurements of muscle torque of hip flexors and extensors were taken with a Biodex System. All measurements were taken under isokinetic (60°/s and 120°/s) and isometric conditions. The symmetry index of vertical GRF components was from 7.5 to 11.5%, and anterio-posterior GRF from 6.2 to 9.3%. The symmetry index for muscle torque was from 24.3 to 44% for flexors, from 39 to 50.5% for extensors, and from 28.6 to 50% in the flexor/extensor ratio. Gait asymmetry correlated with muscle torque in hip joint extensors. Therapy which enhances muscle torque may be an effective form of patient therapy. The patient needs to undergo evaluation of their muscle strength and have the therapy programme adjusted to their level of muscle torque deficit.

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Section: Discussionmentioning

confidence: 99%

“…Prolonged asymmetrical loading was found to be a predictor of atrophy in tight stump muscles, overloading, and degenerative changes [ 11 ]. Patients with TFA develop compensatory strategies in order to decrease asymmetry, such as the vaulting strategy or hip hiking [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

Rutkowska-Kucharska

Kowal

Winiarski

2018

Applied Bionics and Biomechanics

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“…To cope with the loss of functionality of prosthetic joints compared to physiologic joints, people with lower limb amputations often modify the kinematics of their contralateral or residual limbs, which results in gait deviations, such as vaulting or pelvic hiking. 1–4 These deviations could be quantified through biomechanical parameters derived from motion capture systems, but the use of such techniques in a clinical environment cannot be considered due to the complexity of the instrumentation and processing required. Thus, some authors have focused on analyzing the impact of gait deviations on global parameters such as gait asymmetry between prosthetic and contralateral limbs.…”

Section: Introductionmentioning

confidence: 99%

Are wearable insoles a validated tool for quantifying transfemoral amputee gait asymmetry?

Loiret

Villa

Dauriac

et al. 2019

Prosthetics &Amp; Orthotics International

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Background: Amputee gait is known to be asymmetrical, especially during loading of the lower limb. Monitoring asymmetry could be useful in quantifying patient performance during rehabilitation. Wearable insoles can provide normal ground reaction force asymmetry in real-life conditions. Objectives: To characterize the validity of Loadsol® insoles versus force plates in quantifying normal ground reaction force and gait asymmetry. To determine the influence walking speed has on loading asymmetry in transfemoral amputees. Study design: This is a prospective study. Methods: Six transfemoral amputees, wearing Loadsol® insoles, walked at three self-selected speeds on force plates. Validity was assessed by comparing normal ground reaction force data from the insoles and force plates. The Absolute Symmetry Index was used to calculate gait loading asymmetry at each speed. Results: Normalized root mean square errors for the normal ground reaction forces were 6.6% (standard deviation = 2.3%) and 8.9% (standard deviation = 3.8%); correlation coefficients were 0.91 and 0.95 for the prosthetic and intact limb, respectively. The mean error for Absolute Symmetry Index parameters ranged from −2.67% to 4.35%. Loading asymmetry increased with walking speed. Conclusion: This study quantified the validity of Loadsol® insoles in assessing loading asymmetry during gait in transfemoral amputees. The calibration protocol could be improved to better integrate it into a clinical setting. However, our results support the relevance of using such insoles during the clinical follow-up of transfemoral amputees. Clinical relevance This is the first study to validate Loadsol® insoles versus force plates and report on loading asymmetry during gait at three different speeds in transfemoral amputees. Loadsol® insoles, which provide visual and audio feedback, are clinically easy to use and could have beneficial application in the amputee’s rehabilitation and follow-up.

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“…The prosthetic side showed higher values, particularly in the case of TO detection during RD as shown in Table III. This could be due to system errors such as improper placement of the footswitches, movement of the insole inside the shoe during ambulation, variation in the kinematics of the transfemoral amputee compared to able-bodied subjects and also prosthesis performance [26]. In addition, subject based constraints such as knee-ankle adaptability, particularly in the case of ramp activities and the use of these prosthetics for relatively short periods of time (each prosthetic leg was used for a week or two before the experiment) could also be potential explanations for the observed high TD values.…”

Section: Lack Of Proper Tomentioning

confidence: 99%

A Real-Time Gait Event Detection for Lower Limb Prosthesis Control and Evaluation

Maqbool

Husman

Awad

et al. 2017

IEEE Trans. Neural Syst. Rehabil. Eng.

103

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Abstract-Lower extremity amputees suffer from mobility limitations which will result in a degradation of their quality of life. Wearable sensors are frequently used to assess spatiotemporal, kinematic and kinetic parameters providing the means to establish an interactive control of the amputee-prosthesisenvironment system. Gait events and the gait phase detection of an amputee's locomotion are vital for controlling lower limb prosthetic devices. The paper presents an approach to real-time gait event detection for lower limb amputees using a wireless gyroscope attached to the shank when performing level ground and ramp activities. The results were validated using both healthy and amputee subjects and showed that the time differences in identifying Initial Contact (IC) and Toe Off (TO) events were larger in a transfemoral amputee when compared to the control subjects and a transtibial amputee (TTA). Overall, the time difference latency lies within a range of ± 50 ms while the detection rate was 100% for all activities. Based on the validated results, the IC and TO events can be accurately detected using the proposed system in both control subjects and amputees when performing activities of daily living and can also be utilized in the clinical setup for rehabilitation and assessing the performance of lower limb prosthesis users.

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Evolution of vaulting strategy during locomotion of individuals with transfemoral amputation on slopes and cross-slopes compared to level walking

Cited by 20 publications

References 17 publications

Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

Relationship between Asymmetry of Gait and Muscle Torque in Patients after Unilateral Transfemoral Amputation

Are wearable insoles a validated tool for quantifying transfemoral amputee gait asymmetry?

A Real-Time Gait Event Detection for Lower Limb Prosthesis Control and Evaluation

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