Biomechanical responses of individuals with transtibial amputation stepping on a coronally uneven and unpredictable surface

Cyr, Krista M.; Segal, Ava D.; Neptune, Richard R.; Klute, Glenn K.

doi:10.1016/j.jbiomech.2023.111622

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…As a result, the mediolateral foot position affected the severity of the perturbation by causing slight differences in the vertical contact point. However, the vertical center-of-mass position and vertical GRF impulse were found to be unchanged between conditions in previous work [20], suggesting the vertical change in foot position did not significantly impact the results.…”

Section: Limitationsmentioning

confidence: 55%

“…Then, all subjects walked at their self-selected speed over-ground on a walkway embedded with five force plates (AMTI, Watertown, MA, USA), with the center plate of the walkway (Kistler, Winterthur, Switzerland) oriented in three different conditions: flush or rotated coronally ±15 degrees to cause ankle inversion or eversion. The rotation of the plate was positioned manually and recessed into the walkway (see ref [20]). The subjects first completed steady-state trials where the plate rotation was visible for each condition to become acclimated to the study conditions.…”

Section: A Experimental Datamentioning

confidence: 99%

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Simulated Able-Bodied Lower-Limb Joint Loading While Walking on Unexpected Uneven Terrain

Stewart,

Klute,

Neptune

2023

Preprint

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<p>Walking on uneven terrain is a common task throughout daily living and can cause changes in lower-limb kinematics and mechanics. Joint loading, while difficult to measure experimentally, may also increase on uneven terrain, which could contribute to the development of joint pain and debilitating conditions. This study investigated how lower-limb joint loading is affected during a step on coronally-uneven terrain and during the subsequent recovery step using data from individuals without mobility impairments (n=5) and musculoskeletal modeling and simulation, which can be used to reliably estimate joint contact forces. The simulations indicated changes in joint loading during both the uneven and recovery steps on uneven terrain compared to level-ground walking, and these changes varied throughout stance. During both the uneven and recovery steps, the largest increases in peak joint contact forces and impulses were at the ankle joint during early stance. These results suggest that individuals may rely more on early compensations at the ankle than compensations at the hip or knee throughout stance. Future work should include populations with mobility impairments and investigate if different compensatory strategies or interventions can influence the outcomes.</p>

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Section: Limitationsmentioning

confidence: 55%

Section: A Experimental Datamentioning

confidence: 99%

Simulated Able-Bodied Lower-Limb Joint Loading While Walking on Unexpected Uneven Terrain

Stewart,

Klute,

Neptune

2023

Preprint

View full text Add to dashboard Cite

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Influence of Walking Over Unexpected Uneven Terrain on Joint Loading for Individuals With Transtibial Amputation

Stewart,

Klute,

Neptune

2024

Journal of Biomechanical Engineering

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Individuals with transtibial amputation (TTA) experience asymmetric lower-limb loading which can lead to joint pain and injuries. However, it is unclear how walking over unexpected uneven terrain affects their loading patterns. This study sought to use modeling and simulation to determine how peak joint contact forces and impulses change for individuals with unilateral TTA during an uneven step and subsequent recovery step and how those patterns compare to able-bodied individuals. We expected residual limb loading during the uneven step and intact limb loading during the recovery step would increase relative to flush walking. Further, individuals with TTA would experience larger loading increases compared to able-bodied individuals. Simulations of individuals with TTA showed during the uneven step, changes in joint loading occurred at all joints except the prosthetic ankle relative to flush walking. During the recovery step, intact limb joint loading increased in early stance relative to flush walking. Simulations of able-bodied individuals showed large increases in ankle joint loading for both surface conditions. Overall, increases in early stance knee joint loading were larger for those with TTA compared to able-bodied individuals during both steps. These results suggest that individuals with TTA experience altered joint loading patterns when stepping on uneven terrain. Future work should investigate whether an adapting ankle-foot prosthesis can mitigate these changes to reduce injury risk.

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Biomechanical responses of individuals with transtibial amputation stepping on a coronally uneven and unpredictable surface

Cited by 2 publications

References 21 publications

Simulated Able-Bodied Lower-Limb Joint Loading While Walking on Unexpected Uneven Terrain

Simulated Able-Bodied Lower-Limb Joint Loading While Walking on Unexpected Uneven Terrain

Influence of Walking Over Unexpected Uneven Terrain on Joint Loading for Individuals With Transtibial Amputation

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