Global Muscle Coactivation of the Sound Limb in Gait of People with Transfemoral and Transtibial Amputation

Tatarelli, Antonella; Serrao, Mariano; Varrecchia, Tiwana; Fiori, Lorenzo; Draicchio, Francesco; Silvetti, Alessio; Conforto, Silvia; Marchis, Cristiano De; Ranavolo, Alberto

doi:10.3390/s20092543

Cited by 22 publications

(22 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The analysis on a population of TTA, TFA, and controls highlighted that people with amputation had a coactivation profile similar to the control population. However, the prosthetic gait led to an increased level of simultaneous activation during the loading response and push-off phases, whereas this coactivation was decreased during midstance and swing ( 46 ). This increased coactivation probably plays a role in the prosthetic gait asymmetry and altered energy consumption (III-C IND ).…”

Section: Resultsmentioning

confidence: 99%

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Marchis

Ranaldi

Varrecchia

et al. 2022

Front. Rehabilit. Sci.

Self Cite

View full text Add to dashboard Cite

Prosthetic gait implies the use of compensatory motor strategies, including alterations in gait biomechanics and adaptations in the neural control mechanisms adopted by the central nervous system. Despite the constant technological advancements in prostheses design that led to a reduction in compensatory movements and an increased acceptance by the users, a deep comprehension of the numerous factors that influence prosthetic gait is still needed. The quantitative prosthetic gait analysis is an essential step in the development of new and ergonomic devices and to optimize the rehabilitation therapies. Nevertheless, the assessment of prosthetic gait is still carried out by a heterogeneous variety of methodologies, and this limits the comparison of results from different studies, complicating the definition of shared and well-accepted guidelines among clinicians, therapists, physicians, and engineers. This perspective article starts from the results of a project funded by the Italian Worker's Compensation Authority (INAIL) that led to the generation of an extended dataset of measurements involving kinematic, kinetic, and electrophysiological recordings in subjects with different types of amputation and prosthetic components. By encompassing different studies published along the project activities, we discuss the specific information that can be extracted by different kinds of measurements, and we here provide a methodological perspective related to multimodal prosthetic gait assessment, highlighting how, for designing improved prostheses and more effective therapies for patients, it is of critical importance to analyze movement neural control and its mechanical actuation as a whole, without limiting the focus to one specific aspect.

show abstract

Section: Resultsmentioning

confidence: 99%

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Marchis

Ranaldi

Varrecchia

et al. 2022

Front. Rehabilit. Sci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Aside from that, BF loses its connection to the fibula and tibia, RF loses its connection to the base of the patella, and AM loses the hamstring portion of its insertion to the femur's adductor tubercle. The example above showed the modification of muscles' role to adapt to the prosthetic device [ 30 ]. As a result, prosthesis wearers with unaffected lower limbs will develop a balanced strategy to compensate for the absence of the ankle joint and muscles resulting from amputation.…”

Section: Discussionmentioning

confidence: 99%

Effect of Lower Limb Muscle Fatigue on Fall Risk for Transfemoral Amputee: A Pilot Study

Safee

Osman

2021

Occupational Therapy International

View full text Add to dashboard Cite

Muscle fatigue is a decline in muscle maximum force during contraction and can influence the fall risk among people. This study is aimed at identifying the effect of fatigue on prospective fall risk in transfemoral amputees (TFA). Fourteen subjects were involved in this study with TFA ( 34.7 ± 8.1 yrs, n = 7 ) and normal subjects ( 31.1 ± 7.4 yrs, n = 7 ). Fatigue of lower limb muscles was induced with the fatigue protocol. Subjects were tested prefatigue and postfatigue using the standardized fall risk assessment. All results were calculated and compared between pre- and postfatigue to identify fatigue’s effect on both groups of subjects. The results showed that the fall risk increased significantly during pre- and postfatigue for TFA ( p = 0.018 ), while there were no significant differences in normal subjects ( p = 0.149 ). Meanwhile, the fall risk between TFA and normal subjects for prefatigue ( p = 0.082 ) and postfatigue ( p = 0.084 ) also showed no significant differences. The percentage (%) of increased fall risk for TFA was 19.2% compared to normal subjects only 16.7%. However, 61.4% increased of % fall risk in TFA after fatigue by using the baseline of the normal subject as the normalized % of fall risk. The increasing fall risks for TFA after fatigue are three times higher than the potential fall risk in normal subjects. The result indicates that they need to perform more precautions while prolonging lower limb activities. These results showed the implications of fatigue that can increase the fall risk due to muscle fatigue from repetitive and prolonged activities. Therefore, rehabilitation programs can be done very safely and precisely so that therapists can pursue fitness without aggravating existing injuries.

show abstract

“…The proximal muscles registered a decrease in CC between T1 and o-RAGT 1 (PAT02, PAT06, PAT18, PAT20) and between T1 and T2 (PAT02, PAT11, PAT14, PAT18), while the distal muscles did not. In the future, an advanced analysis of sEMG (by means of a time-varying multi-muscle coactivation function) could help to investigate the o-RAGT effects, in terms of simultaneous coactivation of a group of muscles during gait (37)(38)(39). The RMS revealed differences between the same muscles of different limbs, although the one-way ANOVA did not reveal statistical significance.…”

Section: Semg Outcomesmentioning

confidence: 97%

Barriers to sEMG Assessment During Overground Robot-Assisted Gait Training in Subacute Stroke Patients

et al. 2020

View full text Add to dashboard Cite

Background: The limitation to the use of ElectroMyoGraphy (sEMG) in rehabilitation services is in contrast with its potential diagnostic capacity for rational planning and monitoring of the rehabilitation treatments, especially the overground Robot-Assisted Gait Training (o-RAGT). Objective: To assess the barriers to the implementation of a sEMG-based assessment protocol in a clinical context for evaluating the effects of o-RAGT in subacute stroke patients. Methods: An observational study was conducted in a rehabilitation hospital. The primary outcome was the success rate of the implementation of the sEMG-based assessment. The number of dropouts and the motivations have been registered. A detailed report on difficulties in implementing the sEMG protocol has been edited for each patient. The educational level and the working status of the staff have been registered. Each member of staff completed a brief survey indicating their level of knowledge of sEMG, using a five-point Likert scale. Results: The sEMG protocol was carried out by a multidisciplinary team composed of Physical Therapists (PTs) and Biomedical Engineers (BEs). Indeed, the educational level and the expertise of the members of staff influenced the fulfillment of the implementation of the study. The PTs involved in the study did not receive any formal education on sEMG during their course of study. The low success rate (22.7%) of the protocol was caused by several factors which could be grouped in: patient-related barriers; cultural barriers; technical barriers; and administrative barriers. Conclusions: Since a series of barriers limited the use of sEMG in the clinical rehabilitative environment, concrete actions are needed for disseminating sEMG in rehabilitation services. The sEMG assessment should be included in health systems regulations and specific education should be part of the rehabilitation professionals' curriculum.

show abstract

Global Muscle Coactivation of the Sound Limb in Gait of People with Transfemoral and Transtibial Amputation

Cited by 22 publications

References 56 publications

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Characterizing the Gait of People With Different Types of Amputation and Prosthetic Components Through Multimodal Measurements: A Methodological Perspective

Effect of Lower Limb Muscle Fatigue on Fall Risk for Transfemoral Amputee: A Pilot Study

Barriers to sEMG Assessment During Overground Robot-Assisted Gait Training in Subacute Stroke Patients

Contact Info

Product

Resources

About