Relief of knee flexion contracture and gait improvement following adaptive training for an assist device in a transtibial amputee: A case study

Kim, Solbi; Ko, Chang-Yong; Son, Jinho; Kang, Sungjae; Ryu, Jeicheong; Mun, Mingyon

doi:10.3233/bmr-160736

Cited by 3 publications

(10 citation statements)

References 31 publications

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“…Besides not being a primary study and not including a human participant, 268 abstracts were excluded during screening because they concerned arthroplasties, endoprostheses, surgical techniques/experiences/options, postoperative care/treatments/complications, upper limb prostheses, and flexion angles <25 or mild contractures. After full-text selection, 13 studies published between 1958 and 2017 were included for methodological quality assessment (Inter observer agreement ¼ 94%, kappa ¼ 0.88) [34][35][36][37][38][39][40][41][42][43][44][45][46], and 20 studies were excluded [9,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65]. Studies translated into English included three studies written in Russian [34,54,65], and 3 studies written in Dutch [51], Croatian [39], and Polish [56], respectively.…”

Section: Resultsmentioning

confidence: 99%

“…An increase in socket flexion can create excessive pressure on the anterior proximal tibia, the patellar tendon, the patella of a TT residual limb, and the posterior aspect of a TF residual limb. For that reason, the knee and tibial crest area should be sufficiently supported within the socket, or a liner should be used to disperse the pressure over the residual limb and prevent skin breakdown [36,40,43,46]. Other solutions include using a thigh corset or quadrilateral brim in order to enable appropriate weight distribution between the tibia and thigh [36,38] or using a total contact socket [40,43].…”

Section: Discussionmentioning

confidence: 99%

“…For that reason, the knee and tibial crest area should be sufficiently supported within the socket, or a liner should be used to disperse the pressure over the residual limb and prevent skin breakdown [36,40,43,46]. Other solutions include using a thigh corset or quadrilateral brim in order to enable appropriate weight distribution between the tibia and thigh [36,38] or using a total contact socket [40,43]. During walking, a hip flexion contracture limits the hip extension required for walking stability.…”

Section: Discussionmentioning

confidence: 99%

“…Contracture causes gait asymmetries [18,19,43,73], which are already higher in amputees compared with able-bodied persons (23% force asymmetry in persons with an unilateral lower limb amputation and 10% in able-bodied persons [17]). In the long term, greater force on the intact limb may lead to degeneration of weight-bearing joints and joint pain [17].…”

Section: Discussionmentioning

confidence: 99%

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Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

Poonsiri

Dijkstra

Geertzen

2021

Disability and Rehabilitation

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Purpose: In persons with a hip or knee flexion contracture 25 , fitting a prosthesis is said to be difficult. This systematic review aims to assess the evidence for fitting of a prosthesis in persons with a severe contracture (25) after a lower limb amputation. Method: PubMed, Embase, Scopus, CINAHL, and Orthotics & Prosthetics Virtual Library databases were searched from inception to December 2019, using database specific search terms related to amputation, prosthesis, and contracture. Reference lists of included studies were checked for relevant studies. Quality of the included studies was assessed using the critical appraisal checklist for case reports (Joanna Briggs Institute). Results: In total, 13 case studies provided evidence for fitting of a prosthesis in more than 63 persons with a transtibial amputation and three with a transfemoral amputation, all of whom had a hip or knee flexion contracture 25. Some studies found a reduction in contractures after prosthesis use. Conclusions: Several techniques for fitting a prosthesis in case of a flexion contracture 25 were found. Contracture reduction occurred in some cases and was possibly related to prosthesis use. Fitting a transtibial or transfemoral prosthesis in persons with a lower limb amputation with a severe flexion contracture is possible. ä IMPLICATIONS FOR REHABILITATION This study provides information on prosthesis prescriptions and adaptations for persons with a transfemoral and transtibial amputation with a flexion contracture 25. The fitting of bent prostheses is not limited by prosthetic components and techniques. Parallel to the use of bent prostheses, it is also important to treat the contracture.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

Poonsiri

Dijkstra

Geertzen

2021

Disability and Rehabilitation

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“…The marker 3D position data, the ground reaction forces and the real-time image data were identified and measured by real-time software during the gait analysis. The data on each marker were smoothed by Butterworth filters at 6 Hz (Kim et al, 2017). …”

Section: Methodsmentioning

confidence: 99%

Effects of knee sleeves on coordination of lower-limb segments in healthy adults during level walking and one-leg hopping

Ko¹,

Chang²,

Jeong³

et al. 2017

PeerJ

Self Cite

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The evaluation of multisegment coordination is important in gaining a better understanding of the gait and physical activities in humans. Therefore, this study aims to verify whether the use of knee sleeves affects the coordination of lower-limb segments during level walking and one-leg hopping. Eleven healthy male adults participated in this study. They were asked to walk 10 m on a level ground and perform one-leg hops with and without a knee sleeve. The segment angles and the response velocities of the thigh, shank, and foot were measured and calculated by using a motion analysis system. The phases between the segment angle and the velocity were then calculated. Moreover, the continuous relative phase (CRP) was calculated as the phase of the distal segment subtracted from the phase of the proximal segment and denoted as CRPTS (thigh–shank), CRPSF (shank–foot), and CRPTF (thigh–foot). The root mean square (RMS) values were used to evaluate the in-phase or out-of-phase states, while the standard deviation (SD) values were utilized to evaluate the variability in the stance and swing phases during level walking and in the preflight, flight, and landing phases during one-leg hopping. The walking velocity and the flight time improved when the knee sleeve was worn (p < 0.05). The segment angles of the thigh and shank also changed when the knee sleeve was worn during level walking and one-leg hopping. The RMS values of CRPTS and CRPSF in the stance phase and the RMS values of CRPSF in the preflight and landing phases changed (p < 0.05 in all cases). Moreover, the SD values of CRPTS in the landing phase and the SD values of CRPSF in the preflight and landing phases increased (p < 0.05 in all cases). These results indicated that wearing a knee sleeve caused changes in segment kinematics and coordination.

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Clinical Assessment of Gait

Mohamed¹,

Appling²

2020

Orthotics and Prosthetics in Rehabilitation

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Relief of knee flexion contracture and gait improvement following adaptive training for an assist device in a transtibial amputee: A case study

Abstract: ATAD could be beneficial for transtibial amputees by relieving knee contractures and improving gait.

Cited by 3 publications

References 31 publications

Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

Fitting transtibial and transfemoral prostheses in persons with a severe flexion contracture: problems and solutions – a systematic review

Effects of knee sleeves on coordination of lower-limb segments in healthy adults during level walking and one-leg hopping

Clinical Assessment of Gait

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