Differences in the Spatiotemporal Parameters of Transtibial and Transfemoral Amputee Gait

Highsmith, M. Jason; Schulz, Brian W.; Hart-Hughes, Stephanie; Latlief, Gail; Phillips, Sam L.

doi:10.1097/jpo.0b013e3181cc0e34

Cited by 60 publications

(50 citation statements)

References 19 publications

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“…Speed increases are also positively correlated with lower limb amputees' self-perception of gait quality (Miller et al, 2001) and increases in speed not only reflect improved function but also coincide with a decrease in spatio-temporal inter-limb asymmetries (Nolan et al, 2003). As in previous studies (Highsmith et al, 2010;Nolan et al, 2003;Raggi et al, 2009) the results of the present study indicated that TFs had a more temporally asymmetrical gait than TTs.…”

Section: Discussionsupporting

confidence: 69%

Impact on the biomechanics of overground gait of using an ‘Echelon’ hydraulic ankle–foot device in unilateral trans-tibial and trans-femoral amputees

Asha

Munjal

Kulkarni³

et al. 2014

Clinical Biomechanics

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Section: Discussionsupporting

confidence: 69%

Impact on the biomechanics of overground gait of using an ‘Echelon’ hydraulic ankle–foot device in unilateral trans-tibial and trans-femoral amputees

Asha

Munjal

Kulkarni³

et al. 2014

Clinical Biomechanics

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“…The mean walking speed was similar for TTA using ESAR feet (1.29 m/s) or feet with MA units (1.14 m/s). These walking speeds appear to be consistent with observational studies of persons with TTA reporting walking speeds of 1.21 m/s [61]. They also reinforce the previously stated fact that persons with TTA walk slower than people without amputation, who tend to walk between 1.36 and 1.45 m/s [61][62].…”

Section: Feet and Anklessupporting

confidence: 78%

“…These walking speeds appear to be consistent with observational studies of persons with TTA reporting walking speeds of 1.21 m/s [61]. They also reinforce the previously stated fact that persons with TTA walk slower than people without amputation, who tend to walk between 1.36 and 1.45 m/s [61][62]. Perry et al reported that people with TTA using Seattle LightFoot (ESAR) and SA feet walked significantly slower than people without amputation, whereas the walking speed with the FlexFoot (ESAR) was not significantly slower than "normal" [33].…”

Section: Feet and Anklessupporting

confidence: 74%

Prosthetic interventions for people with transtibial amputation: Systematic review and meta-analysis of high-quality prospective literature and systematic reviews

Highsmith¹,

Kahle

Miro

et al. 2016

J Rehabil Res Dev

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Abstract-Considering transtibial amputation (TTA) rehabilitation costs and complexity, high-quality literature should inform clinical practice. Systematic reviews (SRs) suggest this is not the case. This article's purpose was to review the highest-quality evidence available to guide clinical practice for TTA regarding five prosthetic intervention areas. Six databases were searched for high-quality SRs and prospective clinical trials (randomized clinical trials [RCTs]). Reviewers screened, sorted, rated (i.e., methodologic quality, bias risk), and extracted article data. Meta-analyses were conducted when possible. Thirty-one references were included (25 RCTs and 6 SRs). Five topical areas emerged (alignment, feet and ankles, interface, postoperative care, pylons). Twenty-three evidence statements were supported by level 2 evidence and eight by level 1 evidence. All RCTs reported randomization and reasonable data presentation. Concealed allocation and blinding were not widely used. Mean attrition was 11%. SRs included no meta-analyses. Functional level was poorly reported. Grouping feet and ankle components by functional classification enabled meta-analyses, though variance was considerable given the small sample sizes. Prosthetic interventions are generally safe for TTAs. High-quality literature enabled formulation of evidence statements to support select clinical practice areas, though quantity was lacking. Thus, numerous topics related to TTA care lack rigorous evidence. Although blinding in prosthetic research requires increased funding and effort, it could greatly improve the methodologic quality of prosthetic research.Abbreviations: CI = confidence interval, ESAR = energy storing and release, EWA = early walking aid, FK = flexible keel, GRF = ground reaction force, MA = multi-axial, NIH = National Institutes of Health, PEDro = Physiotherapy Evidence Database Scale, PTB = patella tendon bearing, RRD = rigid removable dressing, SA = single axis, SACH = solid ankle cushion heel, SIGN = Scottish Intercollegiate Guidelines Network, SR = systematic review, TSB = total surface bearing, TTA = transtibial amputation, VASS = vacuum-assisted suspension system, vGRF = vertical ground reaction force, VSP = vertical shock pylon.

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“…The walking speed was not, however, significantly different between the two groups. The walking speed recorded in group A was greater than that reported in previous studies in subjects with conventional socket prostheses [39][40][41][42][43]. The greater comfortable walking speed may be the result of the direct transmission of force between the femur and prosthetic limb in individuals with OFs, providing more confidence to load the prosthetic limb.…”

Section: Temporospatial Parameterscontrasting

confidence: 51%

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

Pantall¹,

Ewins²

2013

JRRD

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Abstract-A recent development in prosthetics is the osseointegrated fixation (OF), with improvements in comfort, fatigue, hip movement, and ease of prosthetic attachment reported. However, little information is available regarding muscle function. This study reports on selected gait parameters of the residual limb during the stance phase of level overground walking, focusing on muscle activity. Five males with transfemoral amputation (TFA) with OFs were recruited. Ground reaction force (GRF), lower-limb kinematics, and surface electromyography (sEMG) from residual-limb muscles were recorded. sEMG data were also collected from a group of 10 nondisabled male subjects. Interstance variability of gait parameters was assessed by coefficient of multiple correlations. Repeatability of GRF and hip kinematics was high, whereas repeatability of the sEMG was low for four of the five individuals with TFA. Interstance variability of the sEMG for gluteus medius (GMED) was significantly greater in the group with TFA. The main difference in sEMG between the groups was the phase, with GMED and adductor magnus displaying greater differences than their counterparts in the nondisabled group. Results demonstrate that muscles in the residual limb retain aspects of their previous functional pattern.

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Differences in the Spatiotemporal Parameters of Transtibial and Transfemoral Amputee Gait

Cited by 60 publications

References 19 publications

Impact on the biomechanics of overground gait of using an ‘Echelon’ hydraulic ankle–foot device in unilateral trans-tibial and trans-femoral amputees

Impact on the biomechanics of overground gait of using an ‘Echelon’ hydraulic ankle–foot device in unilateral trans-tibial and trans-femoral amputees

Prosthetic interventions for people with transtibial amputation: Systematic review and meta-analysis of high-quality prospective literature and systematic reviews

Muscle activity during stance phase of walking: Comparison of males with transfemoral amputation with osseointegrated fixations to nondisabled male volunteers

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