Assesment of physical activity in amputees: A systematic review of the literature

Piazza, Lisiane; Ferreira, Elizandra Gonçalves; Minsky, Rafaela Coelho; Pires, Greicy Kelly Wosniak; Silva, R.

doi:10.1016/j.scispo.2017.07.011

Cited by 9 publications

(6 citation statements)

References 36 publications

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“…Although we observed no relationship between PA and the emotional component of SF-36, Da Silva et al 20 reported that PA was positively correlated with psychological QoL, and several previous studies have shown that psychological well-being positively affects PA. 3,31 However, it should be borne in mind that patients with mental health problems, such as depression, may underestimate PA levels in self-reported questionnaires. 32…”

Section: Discussionmentioning

confidence: 99%

Reported physical activity and quality of life in people with lower limb amputation using two types of prosthetic suspension systems

Uçkun

Yurdakul

Almaz

et al. 2019

Prosthetics &Amp; Orthotics International

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Background: Vacuum-assisted suspension systems provide better suspension than non-vacuum systems, but data are limited on whether they improve physical activity levels and quality of life for people with amputation. Objectives: To compare the physical activity and quality of life levels of people with transtibial amputation using PIN/LOCK suspension system or vacuum-assisted suspension systems with those of able-bodied controls and to investigate parameters associated with physical activity levels. Study design: A cross-sectional observational study. Methods: Fifty-one people with amputation and 51 controls participated. The International Physical Activity Questionnaire Short Form and Short Form 36 were used to measure the physical activity and quality of life, respectively. Results: The total physical activity and Short Form 36 scores were significantly lower in the participants with amputation than the controls. There were no significant differences between the two types of suspension systems in terms of physical activity levels and quality of life. The vacuum-assisted suspension system users reported significantly more bodily pain on the Short Form 36 questionnaire than the controls ( p = 0.003). The only parameter that correlated significantly with the total physical activity was the Short Form 36 physical functioning subscale ( r = 0.302, p = 0.031). Conclusion: Contrary to our expectations, vacuum-assisted suspension system users compared to PIN/LOCK users did not report greater levels of physical activity or improved quality of life or levels closer to comparable controls. Clinical relevance A better understanding of the effects of different prosthetic suspension systems on physical activity and quality of life may help clinicians when prescribing prostheses, as well as setting appropriate prosthetic expectations. This study suggests that vacuum-assisted suspension systems and PIN/LOCK suspension systems provide equal benefit to users with regards to physical activity and quality of life.

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Section: Discussionmentioning

confidence: 99%

Reported physical activity and quality of life in people with lower limb amputation using two types of prosthetic suspension systems

Uçkun

Yurdakul

Almaz

et al. 2019

Prosthetics &Amp; Orthotics International

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“…Few studies have examined walking and posture in people with limb absence. A systematic review was conducted on instruments and methods for the assessment of physical activity in people with amputation (Piazza, Ferreira, Minsky, Pires, & Silva, 2017). These methods included the use of surveys and questionnaires, pressure monitors, and instruments such as the StepWatch ™ Activity Monitor.…”

mentioning

confidence: 99%

Reliability and Criterion-Related Validity of the activPAL™ Accelerometer When Measuring Physical Activity and Sedentary Behavior in Adults With Lower Limb Absence

Deans

Kirk

McGarry

et al. 2020

Journal for the Measurement of Physical Behaviour

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Introduction: Accurate measurement of physical behavior in adults with lower limb absence is essential to report true patterns of physical behavior and the effectiveness of interventions. The effect of placing accelerometers on prostheses may also affect the reliability and validity. Purpose: To assess reliability and criterion-related validity of the activPAL for measuring incidental and purposeful stepping, and reclining and stepping time in adults with unilateral lower limb absence. Methods: 15 adults with unilateral lower limb absence completed simulated lifestyle activities in a laboratory setting that were retrospectively scored via video analysis. Objective data were obtained simultaneously from two activPAL monitors placed on the sound and prosthetic side. Data were analyzed using one-way intraclass correlation coefficients (ICC), paired t-tests and Cohen’s d. Results: Reliability (prosthetic side vs. sound side) was poor for incidental steps (ICC = .05, d = 0.48) but acceptable for all other measures (ICC = .77–.88; d = .00–.18). Mean activPAL measures, although highly related to the criterion, underestimated, on average, stepping and time-related variables. Differences were large for all stepping variables (d = .38–.96). Conclusions: The activPAL is a reliable measurement tool in adults with lower limb absence when used in a laboratory setting. Placement of the monitor on the sound side limb is recommended for testing. The activPAL shows evidence of relative validity, but not absolute validity. Further evaluation is needed to assess whether similar evidence is found in free-living activity and sedentary contexts.

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“…Amputees suffer from poor gait due to muscle imbalances, and significant compensatory mechanisms are required to adapt to the loss of muscle and joints [ 1 ]. This results in musculoskeletal problems, increased energetic cost of locomotion and an increased risk of falling [ 2 , 3 , 4 ]. The next generation of prostheses aims to replicate the lost power generating functionality of muscles to improve gait.…”

Section: Introductionmentioning

confidence: 99%

Understanding LSTM Network Behaviour of IMU-Based Locomotion Mode Recognition for Applications in Prostheses and Wearables

Sherratt

Plummer

Iravani

2021

Sensors

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Human Locomotion Mode Recognition (LMR) has the potential to be used as a control mechanism for lower-limb active prostheses. Active prostheses can assist and restore a more natural gait for amputees, but as a medical device it must minimize user risks, such as falls and trips. As such, any control system must have high accuracy and robustness, with a detailed understanding of its internal operation. Long Short-Term Memory (LSTM) machine-learning networks can perform LMR with high accuracy levels. However, the internal behavior during classification is unknown, and they struggle to generalize when presented with novel users. The target problem addressed in this paper is understanding the LSTM classification behavior for LMR. A dataset of six locomotive activities (walking, stopped, stairs and ramps) from 22 non-amputee subjects is collected, capturing both steady-state and transitions between activities in natural environments. Non-amputees are used as a substitute for amputees to provide a larger dataset. The dataset is used to analyze the internal behavior of a reduced complexity LSTM network. This analysis identifies that the model primarily classifies activity type based on data around early stance. Evaluation of generalization for unseen subjects reveals low sensitivity to hyper-parameters and over-fitting to individuals’ gait traits. Investigating the differences between individual subjects showed that gait variations between users primarily occur in early stance, potentially explaining the poor generalization. Adjustment of hyper-parameters alone could not solve this, demonstrating the need for individual personalization of models. The main achievements of the paper are (i) the better understanding of LSTM for LMR, (ii) demonstration of its low sensitivity to learning hyper-parameters when evaluating novel user generalization, and (iii) demonstration of the need for personalization of ML models to achieve acceptable accuracy.

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Assesment of physical activity in amputees: A systematic review of the literature

Cited by 9 publications

References 36 publications

Reported physical activity and quality of life in people with lower limb amputation using two types of prosthetic suspension systems

Reported physical activity and quality of life in people with lower limb amputation using two types of prosthetic suspension systems

Reliability and Criterion-Related Validity of the activPAL™ Accelerometer When Measuring Physical Activity and Sedentary Behavior in Adults With Lower Limb Absence

Understanding LSTM Network Behaviour of IMU-Based Locomotion Mode Recognition for Applications in Prostheses and Wearables

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