Vacuum level effects on gait characteristics for unilateral transtibial amputees with elevated vacuum suspension

Xu, Hang; Greenland, Kasey; Bloswick, Donald S.; Zhao, Jie

doi:10.1016/j.clinbiomech.2017.02.008

Cited by 16 publications

(16 citation statements)

References 24 publications

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“…3 On the other hand, the result of the present study was concordant with the results of a previous study which implied that the residual limb activity had instable pattern. 28 There were limitations of the present study. An important restrictive factor was that the present study does not provide any information on whether the use of another type of prosthetic component design would change the results or not.…”

Section: Discussionmentioning

confidence: 80%

Comparison of gait variability and symmetry in trained individuals with transtibial and transfemoral limb loss

Keklicek

Kirdi

Yalcin

et al. 2019

J Orthop Surg (Hong Kong)

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Gait variability is a determinant of qualified locomotion and is useful for monitoring the effects of therapeutic interventions. The aim of this study was to compare gait variability and symmetry in trained individuals with transtibial (TT) amputation and transfemoral (TF) amputation. Methods: The design of this study was planned as observational. Eleven individuals with TF amputation, 14 individuals with TT amputation, and 14 healthy individuals (HI) were evaluated with a motorized treadmill. The mean step length, the step length variability, an ambulation index, and the time on each foot (stance phase symmetry) of participants were recorded. Results: There were differences between the three groups in the residual/non-preferred limb (RNp) step length (p ¼ 0.031), the intact/preferred (IP) limb step length variability (p ¼ 0.001), the RNp step length variability (p < 0.001), the time on each foot (p < 0.001), and the ambulation index score (p < 0.001). There was a similarity between the groups (TF, TT, HI) in IP limb step lengths (p ¼ 0.127) and duration of prosthesis usage since amputation in individuals with lower limb loss (p ¼ 0.224). Conclusions: This study provided basic data about gait variability and symmetry in individuals with traumatic lower limb loss. The results of the study showed that the variability of gait increased with the level of loss, and individuals with TT amputation showed partially equivalent performance with the healthy group. Similarities in gait characteristics may have resulted from effective prosthetic usage or effective gait rehabilitation.

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Section: Discussionmentioning

confidence: 80%

Comparison of gait variability and symmetry in trained individuals with transtibial and transfemoral limb loss

Keklicek

Kirdi

Yalcin

et al. 2019

J Orthop Surg (Hong Kong)

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“…Xu et al . [ 29 ] recommended a moderate level of 50 kPa to optimize comfort and gait symmetry; their pressures were manually pulled rather than induced by the mechanical pump. The minimum pressures observed at the completion of the 2-Minute Walk test during our study were -34.6 ± 7.7 kPa.…”

Section: Discussionmentioning

confidence: 99%

“…Xu et al . (2017) developed a pressure measurement system to induce a specific vacuum level in order to study the effect on gait parameters, but did not report the changes in vacuum pressure throughout the trials [ 29 ]. The LimbLogic VS Communicator (Ohio Willow Wood) has been developed to measure socket air pressure in real-time [ 13 , 25 , 30 ], however it is only designed to interface with the LimbLogic VS system, limiting its usability across a wider range of systems.…”

Section: Introductionmentioning

confidence: 99%

Real time monitoring of transtibial elevated vacuum prostheses: A case series on socket air pressure

Schoepp

Schofield²,

Home

et al. 2018

PLoS ONE

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Prosthetic elevated vacuum is a suspension method used to reduce daily volume changes of the residual limb. Evaluation of the effectiveness of these systems is limited due to a lack of correlation to actual socket air pressure, particularly during unconstrained movements. This may explain some of the variability in functional outcomes reported in the literature. Our objective was to develop a light-weight portable socket measurement system to quantify internal socket air pressure, temperature, and acceleration; and to present preliminary results from implementation with three transtibial prosthesis users with mechanical elevated vacuum pumps. Participants completed five functional tasks with and without the vacuum pumps actively connected, including the 2-Minute Walk test, 5-Times Sit-to-Stand test, 4-Square Step test, L-Test, and Figure-8 test. Results demonstrated different gait profiles and pressure ranges for each user. Two of the participants demonstrated substantially lower air pressure (higher vacuum) over time while the pump was active compared to inactive. The minimum air pressure measured for all participants was -34.6 ± 7.7 kPa. One participant did not show substantial changes in pressure over time for either pump condition. Functional task performance was not significantly different between pump conditions. Correlation with accelerometer readings indicated peak positive pressures occurred just following initial contact of the foot in early stance, and the most negative pressures (highest vacuum) were observed throughout swing. This study has demonstrated the use of a portable data logging tool that may serve the clinical and research communities to quantify the operation of elevated vacuum systems, and better understand the variability of mechanical pump operation and overall system performance.

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“…Xu et al (2017) also applied vacuum levels of 0, 5, 10, 15, and 20 inHg to explore vacuum level effects on gait characteristics for unilateral transtibial amputees. They reported no statistically significant effects on temporal-spatial parameters [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, gait with different vacuum suspension systems have only been studied on level ground. Although gait differences between active and inactive vacuum conditions were small over level ground [ 5 , 8 , 10 , 16 ], elevated vacuum suspension has shown to improve proprioception and fit [ 1 , 2 , 5 , 6 , 7 , 8 ], which could have a considerable impact on gait for more challenging walking surfaces. Therefore, research is needed to better understand walking performance for individuals with a transtibial amputation when walking with the Unity system on non-level surfaces.…”

Section: Introductionmentioning

confidence: 99%

Effects of the unity vacuum suspension system on transtibial gait for simulated non-level surfaces

Thibault¹,

Gholizadeh²,

Sinitski³

et al. 2018

PLoS ONE

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Walking on various surfaces encountered in everyday life requires lower limb prosthesis users to continually adapt their movement patterns. Elevated vacuum suspension systems could improve transtibial amputee gait on non-level surfaces; however, research is lacking to guide clinical practice. Twelve transtibial amputees were fitted with the Össur sleeveless vacuum suspension system (Unity). After a one month accommodation period, the CAREN-Extended system was used to evaluate gait on a self-paced treadmill when walking with continuous perturbations (medial-lateral translations, rolling hills, simulated uneven ground) with an active or inactive vacuum suspension system. Significant differences between active and inactive vacuum conditions (p<0.05) were found for some temporal-spatial and kinematic gait parameters, but the differences were small and not considered clinically significant. Our findings suggest that potential vacuum pump failures would not immediately affect gait performance in a moderately high functioning amputee population. However, residual limb volume changes over time due to the removal of elevated vacuum may adversely affect socket fit, leading to greater gait differences and reduced quality of life.

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Vacuum level effects on gait characteristics for unilateral transtibial amputees with elevated vacuum suspension

Cited by 16 publications

References 24 publications

Comparison of gait variability and symmetry in trained individuals with transtibial and transfemoral limb loss

Comparison of gait variability and symmetry in trained individuals with transtibial and transfemoral limb loss

Real time monitoring of transtibial elevated vacuum prostheses: A case series on socket air pressure

Effects of the unity vacuum suspension system on transtibial gait for simulated non-level surfaces

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