Metabolic cost of transport and stance time asymmetry in individuals with unilateral transtibial amputation using a passive prostheses while walking

Wedge, Ryan D.; Sup, Frank C.; Umberger, Brian R.

doi:10.1016/j.clinbiomech.2022.105632

Cited by 9 publications

(4 citation statements)

References 32 publications

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“…track the able-bodied experimental data more closely, would be expected to increase metabolic cost. Previous simulations and experiments on human participants have also suggested that altering the gait mechanics to be more symmetric in individuals with unilateral lower limb loss comes with substantial increases in metabolic cost (Handford & Srinivasan, 2016;Wedge et al, 2022). A Pareto front between the two cost function terms in these simulations, gait deviations and metabolic cost, including conditions of direct tracking of gait mechanics from individuals with transfemoral limb loss, would be a useful direction for future work to elaborate on the relationship between gait deviations and metabolic cost.…”

Section: Discussionmentioning

confidence: 85%

Transfemoral limb loss modestly increases the metabolic cost of optimal control simulations of walking

Miller

Bell

Esposito

2023

Preprint

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Unlike the case of transtibial limb loss, high-functioning military service members with transfemoral limb loss have a high metabolic cost of walking compared to able-bodied peers. In transtibial limb loss, computer simulations suggest that the maintenance of muscle strength between pre- and post-limb loss can maintain the pre-limb loss metabolic cost. Here we performed optimal control simulations of walking with and without transfemoral limb loss to determine if transfemoral limb loss per se increases the metabolic cost of walking. OpenSim Moco was used to generate optimal control simulations of walking in 15 virtual subjects that minimized the weighted sum of (i) deviations from average able-bodied gait mechanics and (ii) the gross metabolic cost of walking, pre-limb loss in models with two intact biological limbs, and post-limb loss with one of the limbs replaced by a transfemoral prosthesis. No other changes were made to the model. Metabolic cost post-limb loss increased by 0.7-9.3% (p < 0.01) depending on whether cost was scaled by total body mass or biological body mass and on whether the prosthetic knee was passive or non-passive. The post-limb loss model had numerous features that predisposed it to low metabolic cost. These results suggest that transfemoral limb loss per se increases the metabolic cost of walking, but that the large differences above able-bodied peers of ~20-45% in most gait analysis experiments may be avoidable, even when minimizing deviations from able-bodied gait mechanics.

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Section: Discussionmentioning

confidence: 85%

Transfemoral limb loss modestly increases the metabolic cost of optimal control simulations of walking

Miller

Bell

Esposito

2023

Preprint

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“…[21]. Other authors showed that amputees walked symmetrically, but had stance-time asymmetry, and the metabolic cost of symmetrical walking was 13.6% higher [22].…”

Section: Discussionmentioning

confidence: 98%

Clinical and Demographic Factors Influencing the Asymmetry of Gait in Lower-Limb Prosthetic Users

Dąbrowski

Łysakowska

Gramala³

et al. 2022

Symmetry

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(1) Background: A lower limb prosthesis replaces a lost body part with a differential representation of gait function and its symmetry. Many physical, personal, and specific factors in amputees influence gait asymmetry. The aim of this study was to determine the factors influencing the asymmetry of gait in amputated patients. (2) Methods: The study group consisted of 12 people. Gait quality was assessed using the MoCap OptiTrack® Motion Capture System and the results were correlated with demographic factors (age, gender), morphological features (height, weight), amputation-related factors (cause and side of amputation, prosthesis time, and prosthesis fixation), and ailment pain. The control group consisted of 12 people. (3) Results: In the study group, a positive correlation between the mean walking speed and height in the study group was demonstrated, as well as a positive correlation between the difference in ROM and height, and a negative correlation between the mean walking speed and age. A negative correlation between the difference in ROM and age was found in both groups. A positive correlation was found between the width of the support and the weight in the control group. No other statistical relationship with the parameters describing gait asymmetry was found. (4) Conclusions: Statistical analysis showed that mean walking speed and ROM difference in the study group were positively related to height and negatively to age. No other statistical relationship with the parameters describing gait asymmetry was found.

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“…After acquiring locomotion, the metabolic costs of transport and the symmetry of spatiotemporal gait factors were evaluated to identify reasonable locomotion scenarios for activities of daily living in individuals with UTTA. According to a previous study, individuals with UTTA altered their gait patterns to optimize the metabolic costs of transport (Wedge et al, 2022). Therefore, we hypothesized that the asymmetric control scenario, which allows greater flexibility in gait patterns than the symmetric one, could achieve reasonable locomotion in individuals with UTTA.…”

Section: Introductionmentioning

confidence: 99%

“…Individuals with symmetrical body proportions exhibit an energy-efficient gait on flat ground (Wedge et al, 2022). The gait pattern implies symmetrical control of the left and right lower limbs by the CPG.…”

Section: Introductionmentioning

confidence: 99%

Acquisition of bipedal locomotion in a neuromusculoskeletal model with unilateral transtibial amputation

Ichimura

Hobara²,

Hisano³

et al. 2023

Front. Bioeng. Biotechnol.

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Adaptive locomotion is an essential behavior for animals to survive. The central pattern generator in the spinal cord is responsible for the basic rhythm of locomotion through sensory feedback coordination, resulting in energy-efficient locomotor patterns. Individuals with symmetrical body proportions exhibit an energy-efficient symmetrical gait on flat ground. In contrast, individuals with lower limb amputation, who have morphologically asymmetrical body proportions, exhibit asymmetrical gait patterns. However, it remains unclear how the nervous system adjusts the control of the lower limbs. Thus, in this study, we investigated how individuals with unilateral transtibial amputation control their left and right lower limbs during locomotion using a two-dimensional neuromusculoskeletal model. The model included a musculoskeletal model with 7 segments and 18 muscles, as well as a neural model with a central pattern generator and sensory feedback systems. Specifically, we examined whether individuals with unilateral transtibial amputation acquire prosthetic gait through a symmetric or asymmetric feedback control for the left and right lower limbs. After acquiring locomotion, the metabolic costs of transport and the symmetry of the spatiotemporal gait factors were evaluated. Regarding the metabolic costs of transportation, the symmetric control model showed values approximately twice those of the asymmetric control model, whereas both scenarios showed asymmetry of spatiotemporal gait patterns. Our results suggest that individuals with unilateral transtibial amputation can reacquire locomotion by modifying sensory feedback parameters. In particular, the model reacquired reasonable locomotion for activities of daily living by re-searching asymmetric feedback parameters for each lower limb. These results could provide insight into effective gait assessment and rehabilitation methods to reacquire locomotion in individuals with unilateral transtibial amputation.

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Metabolic cost of transport and stance time asymmetry in individuals with unilateral transtibial amputation using a passive prostheses while walking

Cited by 9 publications

References 32 publications

Transfemoral limb loss modestly increases the metabolic cost of optimal control simulations of walking

Transfemoral limb loss modestly increases the metabolic cost of optimal control simulations of walking

Clinical and Demographic Factors Influencing the Asymmetry of Gait in Lower-Limb Prosthetic Users

Acquisition of bipedal locomotion in a neuromusculoskeletal model with unilateral transtibial amputation

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