Limits of Stability in Persons With Transtibial Amputation With Respect to Prosthetic Alignment Alterations

Kolářová, Barbora; Janura, Miroslav; Svoboda, Zdeněk; Elfmark, Milan

doi:10.1016/j.apmr.2013.05.019

Cited by 40 publications

(47 citation statements)

References 30 publications

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“…Though, one should be cautious to apply to the current results to the prosthetic limb as this has not been validated. The results from the CoP data are in line with previous data published regarding the LoS test variables for unilateral transtibial prosthesis users including reduced excursion towards the prosthetic limb and reduced mean velocities [15,17]. One should be conscious that an evaluation of these variables were not in line with the aims of this study, though it suggests valid data was used to address the aims of this study.…”

Section: Discussionsupporting

confidence: 66%

“…It has been shown that LoS outcome variables associated with accuracy and control improve in the 6 months following amputation but not the temporal variables [12]. Transtibial prosthesis users have reduced accuracy in movements directed backwards and towards the prosthesis and reduced limits towards the prosthetic side when compared to controls [15] and alignment changes do not affect these results [17].…”

Section: Introductionmentioning

confidence: 78%

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The validity of forceplate data as a measure of rapid and targeted volitional movements of the centre of mass in transtibial prosthesis users

Rusaw

2016

Disability and Rehabilitation: Assistive Technology

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PostprintThis is the accepted version of a paper published in Disability and Rehabilitation: Assistive Technology. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Rusaw, D. (2017) The validity of forceplate data as a measure of rapid and targeted volitional movements of the center of mass in transtibial prosthesis users. This research was conducted using using funds provided by The Promobilia Foundation (Ref#12066). All authors were fully involved in the study and preparation of the manuscript and that the material within has not been and will not be submitted for publication elsewhere. Disability and Rehabilitation

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 78%

The validity of forceplate data as a measure of rapid and targeted volitional movements of the centre of mass in transtibial prosthesis users

Rusaw

2016

Disability and Rehabilitation: Assistive Technology

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“…After full text assessment 7 studies were excluded [11,17–22] Followed by screening of the reference section of the remaining 11 studies, this did not result in the inclusion of additional studies. The studies included in this review include two controlled before-and-after study design studies and nine-interrupted time series design studies (Table 2).…”

Section: Resultsmentioning

confidence: 99%

The Effect of Alignment Changes on Unilateral Transtibial Amputee’s Gait: A Systematic Review

et al. 2016

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IntroductionProsthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputee’s gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systematic review is to investigate if an optimal alignment criterion can be derived from published articles. Moreover, we investigated the effect of alignment changes on spatiotemporal, kinematic and kinetic gait parameters.ResultsA total of 11 studies were included, two controlled before-and-after studies and nine-interrupted time series studies.DiscussionThe results demonstrate that alignment changes have a predictable influence on the included kinetic parameters. However, the effect of alignment changes on spatio-temporal and kinematic gait parameters are generally unpredictable. These findings suggest that it is imperative to include kinetics in the process of dynamic prosthetic alignment. Partially this can be established by communication with the prosthetic user in terms of perceived socket comfort, but the use of measurement tools should also be considered. While current literature is not conclusive about an optimal alignment, future alignment research should focus on alignment optimisation based on kinetic outcomes.

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“…These posturography studies have revealed increases in measures of postural sway including center of pressure velocity and displacement compared to age-matched controls [11–16]. These differences in postural sway are influenced by age [14,17], cause of limb loss [14], residual limb length [18], level of limb loss [11,15], and time since limb loss [19], but not prosthetic alignment [16,20]. Additionally, the intact leg may contribute substantially more to maintaining static postural stability than the prosthetic leg [21].…”

Section: 0 Introductionmentioning

confidence: 99%

Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control

Bolger

Ting

Sawers

2014

Clinical Biomechanics

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Background Deficits in balance control are one of the most common and serious mobility challenges facing individuals with lower limb loss. Yet, dynamic postural balance control among indivdiuals with lower limb loss remains poorly understood. Here we examined the kinematics and kinetics of dynamic balance in individuals with unilateral transtibial limb loss. Methods Five individuals with unilateral transtibial limb loss, and five age- and gender-matched controls completed a series of randomly applied multi-directional support surface translations. Whole-body metrics, e.g. peak center-of-mass displacement and net center-of-pressure displacement were compared across cohorts. Stability margin was computed as the difference between peak center-of-pressure and center-of-mass displacement. Additionally, center-of-pressure and ground reaction force magnitude and direction were compared between the prosthetic, intact, and control legs. Findings Peak center-of-mass displacement and stability margin did not differ between individuals with transtibial limb loss and controls for all perturbation directions except those loading only the prosthetic leg; in such cases the stability margin was actually larger than controls. Despite similar center-of-mass displacement, greater center-of-pressure displacement was observed in the intact leg during anterior-posterior perturbations, and under the prosthetic leg in medial-lateral perturbations. Further, in the prosthetic leg, ground reaction forces were smaller and spanned fewer directions. Interpretation Deficits in balance control among indivdiuals with transtibial limb loss may be due to their inability to use their prosthetic leg to generate forces that are equal in magnitude and direction to those of unimpaired adults. Targeting this force-generating deficit through technological or rehabilitation innovations may improve balance control.

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Limits of Stability in Persons With Transtibial Amputation With Respect to Prosthetic Alignment Alterations

Cited by 40 publications

References 30 publications

The validity of forceplate data as a measure of rapid and targeted volitional movements of the centre of mass in transtibial prosthesis users

The validity of forceplate data as a measure of rapid and targeted volitional movements of the centre of mass in transtibial prosthesis users

The Effect of Alignment Changes on Unilateral Transtibial Amputee’s Gait: A Systematic Review

Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control

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