Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses

Tranberg, Roy; Zügner, Roland; Kärrholm, Johan

doi:10.1016/j.gaitpost.2010.11.004

Cited by 91 publications

(68 citation statements)

References 21 publications

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“…The median maximum extension of 16.2 was greater than the 9.9 measured previously in individuals with OFs and in subjects with conventional socket prostheses, where the socket constrains movement [48]. In contrast to extension, the median maximum abduction (13.2) recorded during stance was similar to the value of 10 measured in subjects with conventional prostheses [49].…”

Section: Hip Joint Kinematicssupporting

confidence: 38%

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

Pantall¹,

Ewins²

2013

JRRD

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Abstract-A recent development in prosthetics is the osseointegrated fixation (OF), with improvements in comfort, fatigue, hip movement, and ease of prosthetic attachment reported. However, little information is available regarding muscle function. This study reports on selected gait parameters of the residual limb during the stance phase of level overground walking, focusing on muscle activity. Five males with transfemoral amputation (TFA) with OFs were recruited. Ground reaction force (GRF), lower-limb kinematics, and surface electromyography (sEMG) from residual-limb muscles were recorded. sEMG data were also collected from a group of 10 nondisabled male subjects. Interstance variability of gait parameters was assessed by coefficient of multiple correlations. Repeatability of GRF and hip kinematics was high, whereas repeatability of the sEMG was low for four of the five individuals with TFA. Interstance variability of the sEMG for gluteus medius (GMED) was significantly greater in the group with TFA. The main difference in sEMG between the groups was the phase, with GMED and adductor magnus displaying greater differences than their counterparts in the nondisabled group. Results demonstrate that muscles in the residual limb retain aspects of their previous functional pattern.

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Section: Hip Joint Kinematicssupporting

confidence: 38%

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

Pantall¹,

Ewins²

2013

JRRD

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“…Achieving these objectives may be markedly affected by both the site (i.e., limb) and level of the amputation. Transfemoral amputation (TFA), for example, is associated with impaired strength [3][4][5], limited range of motion [6][7], diminished sensation [8][9], and pain [10][11] in the residual limb in addition to the loss of the distal limb (i.e., knee, leg, ankle, foot). Although a lower-limb prosthesis is traditionally provided to replace absent limb structures, its capability to restore function and fulfill users' needs is limited, variable, and not well defined.…”

Section: Introductionmentioning

confidence: 99%

Long-term activity in and among persons with transfemoral amputation

Halsne¹,

Waddingham²,

Hafner³

2013

JRRD

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Abstract-Although physical limitations associated with transfemoral amputation (TFA) have been studied in laboratory settings, little is known about habitual activity within free-living environments. A retrospective analysis of 12 mo of step activity data was performed to quantify activity levels, variations, and patterns in 17 adults with unilateral TFA. Yearly, seasonal, and monthly average daily step counts and coefficients of variation (CoVs) were examined to characterize mobility. Analysis by Medicare Functional Classification Level (MFCL) was performed to explore relationships between clinical classification and performance. Subjects averaged 1,540 prosthetic steps/day, and activity generally increased with MFCL. Activity between MFCL-2 and -3 subjects was not significantly different, suggesting that ability to engage in habitual physical activity may be similar for these groups. Relative variation (CoV) was 0.65 across subjects but was lower for those with higher activity levels. No significant differences in CoV by group were detected. Marked seasonal and monthly patterns in activity were identified. Warmer seasons and months generally promoted higher activity, but peak temperatures and humidity depressed activity. Results suggest that persons with TFA are greatly limited in regards to activity. Further, large variations within and between subjects may challenge the interpretation of step activity gathered over short periods of time.

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“…The bilateral increase in strength is consistent with the improvement in gait pattern and supports the hypothesis that poor gait may be due to hip abductor insufficiency on the prosthetic side (Sjodahl, Jarnlo, Soderberg, and Persson, 2003;Tazawa, 1997). Moving from a SP to an EEFP may have improved gait pattern because of the beneficial effects on hip and pelvic motion, muscle force transmission, and osseoperception (Aschoff, Clausen, Tsoumpris, and Hoffmeister, 2011;Tranberg, Zugner, and Karrholm, 2011). Previous studies also noted an increase in Q-TFA global score after converting from SP to BAP Hagberg, Branemark, Gunterberg, and Rydevik, 2008;Hagberg, Hansson, and Branemark, 2014; Van de Meent, Hopman, and Frolke, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…A comparison of BAP and SP users found that BAP users had a greater hip ROM during use of the prosthesis (Hagberg, Haggstrom, Uden, and Branemark, 2005). Another study reported that BAP use increased hip extension and decreased anterior pelvic tilt compared to SP use, although gait still differed from that of able-bodied persons (Tranberg, Zugner, and Karrholm, 2011). Cadence, duration of the gait cycle, and duration of the support phase of BAP users are also more similar to those of able-bodied persons than of SP users (Frossard et al, 2010b).…”

Section: Introductionmentioning

confidence: 99%

“…Six weeks later, a soft tissue stoma is created, and the transcutaneous osseointegration prosthesis unit is bolted into the implant (Aschoff, Clausen, Tsoumpris, and Hoffmeister, 2011). Improved gait quality represents one potential advantage of a BAP over a SP (Frossard et al, 2010b;Hagberg, Haggstrom, Uden, and Branemark, 2005;Tranberg, Zugner, and Karrholm, 2011). A comparison of BAP and SP users found that BAP users had a greater hip ROM during use of the prosthesis (Hagberg, Haggstrom, Uden, and Branemark, 2005).…”

Section: Introductionmentioning

confidence: 99%

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Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation

Leijendekkers

Hinte

Sanden

et al. 2017

Physiotherapy Theory and Practice

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Background: In patients with a transfemoral amputation socket-related problems are associated with reduced prosthetic use, activity, and quality of life. Furthermore, gait asymmetries are present that may explain secondary complaints. Bone-anchored prostheses (BAPs) may help these patients. Two types of BAP are available, screw and press-fit implants. Rehabilitation following surgery for a press-fit BAP is poorly described. Purpose: To describe a rehabilitation program designed to minimize compensation strategies and increase activity using a case-report of an active, 70-year-old man with a traumatic transfemoral amputation who had used a socket prosthesis for 52 years and received a press-fit BAP [Endo-Exo Femoral Prosthesis -EEFP]. Intervention: A 13-week physiotherapy program. Outcomes: Outcomes were assessed before surgery, at the end of rehabilitation, and six-month and one-year follow-ups. After rehabilitation gait had improved, the patient had more arm movement, more pelvic shift, less hip rotation during swing phase on the prosthetic side, and absence of vaulting on the sound side. Isometric hip abductor strength was 15% higher on the sound side and 16% higher on the prosthetic side, and walking distance increased from 200 m to 1500 m. At the six-month follow-up, the patient had lower back complications and reduced hip abductor strength and walking distance. At oneyear follow-up, walking distance had recovered to 1000 m and gait pattern had improved again, with yielding and absence of terminal impact on the prosthetic side. Conclusion: The described rehabilitation program may be an effective method of improving gait in patients with an EEFP even after long-term socket usage.

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Improvements in hip- and pelvic motion for patients with osseointegrated trans-femoral prostheses

Cited by 91 publications

References 21 publications

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

Long-term activity in and among persons with transfemoral amputation

Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation

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