Relationships between mediolateral trunk-pelvic motion, hip strength, and knee joint moments during gait among persons with lower limb amputation

Butowicz, Courtney M.; Krupenevich, Rebecca L.; Acasio, Julian C.; Dearth, Christopher L.; Hendershot, Brad D.

doi:10.1016/j.clinbiomech.2019.11.009

Cited by 11 publications

(11 citation statements)

References 47 publications

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“…Further studies could associate the loading profiles with complementary mechanical (e.g., dynamics, kinematics, kinetics characteristics), physiological (e.g., electromyography of residuum muscles, metabolic energy consumption) and participant's experience (e.g., comfort score) information (Butowicz et al, 2020;Dumas et al, 2009;Dumas et al, 2017;Frossard et al, 2011b;Kaufman et al, 2018;Pantall et al, 2011). Establishing how prosthetic loading with state-of-the-art components influence the development of osseointegration around the implant and overall stability will be particularly valuable (e.g., modelling) (Helgason et al, 2009;Lee et al, 2008a;Newcombe et al, 2013;Prochor et al, 2020;Robinson et al, 2020a;Schwarze et al, 2014).…”

Section: Future Studiesmentioning

confidence: 99%

Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

Frossard

Laux²,

Geada³

et al. 2021

Clinical Biomechanics

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Background: This study presented the load profile applied on transfemoral osseointegrated implants by boneanchored prostheses fitted with state-of-the-art Ö SSUR microprocessor-controlled Rheo Knee XC and energystoring-and-returning Pro-Flex XC or LP feet during five standardized daily activities. Methods: This cross-sectional cohort study included 13 participants fitted with a press-fit transfemoral osseointegrated implant. Loading data were directly measured with the tri-axial transducer of an iPecsLab (RTC Electronics, USA) fitted between the implant and knee unit. The loading profile was characterized by spatio-temporal gaits variables, magnitude of loading boundaries as well as onset and magnitude of loading extrema during walking, ascending and descending ramp and stairs. Findings: A total of 2127 steps was analysed. The cadence ranged between 36 ± 7 and 47 ± 6 strides/min. The absolute maximum force and moments applied across all activities was 1322 N, 388 N and 133 N as well as 22 Nm, 52 Nm and 88 Nm on and around the long, anteroposterior and mediolateral axes of the implant, respectively. Interpretation: This study provided new benchmark loading data applied by transfemoral bone-anchored prostheses fitted with selected Ö SSUR state-of-the-art components. Outcomes suggested that such prostheses can generate relevant loads at the interface with the osseointegrated implant to restore ambulation effectively. This study is a worthwhile contribution toward a systematic recording, analysis, and reporting of ecological prosthetic loading profiles as well as closing the evidence gaps between prescription and biomechanical benefits of state-ofthe-art components. Hopefully, this will contribute to improve outcomes for growing number of individuals with limb loss opting for bionic solutions.

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Section: Future Studiesmentioning

confidence: 99%

Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

Frossard

Laux²,

Geada³

et al. 2021

Clinical Biomechanics

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“…After the surgery, people with amputation must undergo a rehabilitation phase and a considerable walking training ( 7 ) to gain the ability to walk autonomously and safely with a prosthetic device ( 8 , 9 ). People with mono-lateral amputation typically adopt a series of compensatory motor strategies involving the prosthetic side and the contralateral sound limb ( 10 , 11 ), plus an increased involvement of pelvis and trunk ( 12 – 16 ). As a matter of fact, prosthetic gait reflects a mixture of deviations from normal gait and adaptive and compensatory motions dictated by residual limb functions.…”

Section: Introductionmentioning

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.

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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.

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Section: Introductionmentioning

confidence: 99%

“…The decreased utilization of the prosthetic leg for posture control is compensated by altered biomechanics of the intact non-amputated limb, pelvis, and trunk [8,14]. This might increase the risk of developing pain symptoms [15] and secondary overuse musculoskeletal injury which has a relatively high incidence in lower limb amputees [16] and restricts their functional mobility [14,15]. From this perspective, the research focused on further understanding of underlying adaptive postural control mechanisms in TTA is desired [17,18] as maximizing the engagement of the prosthetic limb for postural control tasks after TTAs seems to play an important role in improving patient outcomes [19] and should be reflected during rehabilitation [2,3], prosthetic alignments, or arrangement of new prosthetic devices [18].…”

Section: Introductionmentioning

confidence: 99%

“…Postural control mechanisms may be measured using computerized dynamic posturography [14,15]. Multiple studies for lower limb amputees used the standardized posturographic protocols of the motor control test (MCT) for the evaluation of automatic postural responses to external perturbations, and the limits of stability test (LOS) for the assessment of the maximum voluntary body inclination without changing the base of support.…”

Section: Introductionmentioning

confidence: 99%

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Postural Control Strategies and Balance-Related Factors in Individuals with Traumatic Transtibial Amputations

Kolářová

Janura

Svoboda

et al. 2021

Sensors

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Mechanisms behind compromised balance control in people with transtibial amputation need to be further explored, as currently little is known specifically about postural control strategies in people with traumatic transtibial amputation (tTTA). The aim of this study is to assess automatic and voluntary postural control strategies in individuals with unilateral tTTA compared to those in control subjects and to define the effect of balance-related factors on these strategies. Automatic posture reactions and volitional motion toward given direction using standardized posturographic protocols (NeuroCom) of the Motor Control Test (MCT) and Limits of Stability (LOS) were assessed in eighteen participants with tTTA and eighteen age-matched controls. Compared to the controls, the participants with tTTA bore less weight on the prosthetic leg (p < 0.001) during the MCT and had reduced inclination toward the prosthetic leg (p < 0.001) within the LOS. In the tTTA group, the weight-bearing symmetry and the inclination toward the prosthetic leg (p < 0.05) was positively correlated with prosthesis use duration (p < 0.05). The current study indicates that decreased utilization of the prosthetic leg in tTTAs represents adaptive postural control strategy, but as prosthesis use duration increased, the engagement of the prosthetic leg improved.

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Relationships between mediolateral trunk-pelvic motion, hip strength, and knee joint moments during gait among persons with lower limb amputation

Cited by 11 publications

References 47 publications

Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

Load applied on osseointegrated implant by transfemoral bone-anchored prostheses fitted with state-of-the-art prosthetic components

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

Postural Control Strategies and Balance-Related Factors in Individuals with Traumatic Transtibial Amputations

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