Effect of prosthetic alignment on gait and biomechanical loading in individuals with transfemoral amputation: A preliminary study

Zhang, Tengyu; Bai, Xuefei; Liu, Fei; Fan, Yubo

doi:10.1016/j.gaitpost.2019.04.026

Cited by 20 publications

(14 citation statements)

References 23 publications

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“…These results may correspond to a reduced lateral GRF peak during the single-support phase of gait and lack of the double-peak in the medial GRF profile from the affected limb. Previous studies found similar differences between the affected and unaffected limbs (Soares et al, 2016;Zhang et al, 2019). These characteristics are possibly related to COM acceleration, which represents the effect of GRF generation.…”

Section: Discussionsupporting

confidence: 56%

“…As the stance time of the affected limb has been reported to be shorter than that of the unaffected limb (Nolan et al, 2003;Hof et al, 2007;Schaarschmidt et al, 2012;Mahon et al, 2017), we hypothesize that the mean mediolateral GRF of the affected limb is higher than that of the unaffected limb. UAK prosthesis users demonstrated a unimodal mediolateral GRF-time curve in the affected limb, while a bimodal in the unaffected limb in a previous study (Zhang et al, 2019). Thus, we hypothesize that the affected limb generates higher mean mediolateral GRF than the unaffected limb, especially at midstance.…”

Section: Introductionmentioning

confidence: 62%

See 1 more Smart Citation

Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy

Hisano

Hashizume

Kobayashi

et al. 2021

Journal of Biomechanics

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 62%

Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy

Hisano

Hashizume

Kobayashi

et al. 2021

Journal of Biomechanics

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“…The changes in Fx, Fy1 and Fy2 for prosthetic and intact limbs as well as in their asymmetry ratios between TFSim and TFAmp groups might be supported by previous studies that reported similar changes across walking speeds [25,40]. Similar asymmetry patterns of mediolateral GRF in the TFSim and TFAmp groups were revealed in a study that compared individuals with unilateral TFAmp and non-disabled individuals [25].…”

Section: Discussionsupporting

confidence: 77%

Transfemoral prosthetic simulators versus amputees: ground reaction forces and spatio-temporal parameters in gait

Kobayashi,

Jor,

et al. 2024

R. Soc. Open Sci.

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This study aimed to compare the ground reaction forces (GRFs) and spatio-temporal parameters as well as their asymmetry ratios in gait between individuals wearing a transfemoral prosthetic simulator (TFSim) and individuals with unilateral transfemoral amputation (TFAmp) across a range of walking speeds (2.0–5.5 km h −1 ). The study recruited 10 non-disabled individuals using TFSim and 10 individuals with unilateral TFAmp using a transfemoral prosthesis. Data were collected using an instrumented treadmill with built-in force plates, and subsequently, the GRFs and spatio-temporal parameters, as well as their asymmetry ratios, were analysed. When comparing the TFSim and TFAmp groups, no significant differences were found among the gait parameters and asymmetry ratios of all tested metrics except the vertical GRFs. The TFSim may not realistically reproduce the vertical GRFs during the weight acceptance and push-off phases. The structural and functional variations in prosthetic limbs and components between the TFSim and TFAmp groups may be primary contributors to the difference in the vertical GRFs. These results suggest that TFSim might be able to emulate the gait of individuals with TFAmp regarding the majority of spatio-temporal and GRF parameters. However, the vertical GRFs of TFSim should be interpreted with caution.

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“…A study that was done in able-bodied individuals also found correlations between higher GRFs and stress fractures [22]. Although there may be a variety of factors such as prosthetic components [54,55], physical conditions [56,57], and other gait parameters such as velocity and motor control [54,58] that can affect GRFs and GRIs on individuals with amputation, our results indicate that increasing step frequency is a viable strategy to reduce GRFs or GRIs. Therefore, reduction of GRFs or GRIs by increasing step frequency may have implications to reduce potential injury risk during running in individuals with amputation.…”

Section: Discussionsupporting

confidence: 55%

Effects of step frequency during running on the magnitude and symmetry of ground reaction forces in individuals with a transfemoral amputation

Kobayashi

Koh

et al. 2022

J NeuroEngineering Rehabil

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Background Individuals with unilateral transfemoral amputation are prone to developing health conditions such as knee osteoarthritis, caused by additional loading on the intact limb. Such individuals who can run again may be at higher risk due to higher ground reaction forces (GRFs) as well as asymmetric gait patterns. The two aims of this study were to investigate manipulating step frequency as a method to reduce GRFs and its effect on asymmetric gait patterns in individuals with unilateral transfemoral amputation while running. Methods This is a cross-sectional study. Nine experienced track and field athletes with unilateral transfemoral amputation were recruited for this study. After calculation of each participant’s preferred step frequency, each individual ran on an instrumented treadmill for 20 s at nine different metronome frequencies ranging from − 20% to + 20% of the preferred frequency in increments of 5% with the help of a metronome. From the data collected, spatiotemporal parameters, three components of peak GRFs, and the components of GRF impulses were computed. The asymmetry ratio of all parameters was also calculated. Statistical analyses of all data were conducted with appropriate tools based on normality analysis to investigate the main effects of step frequency. For parameters with significant main effects, linear regression analyses were further conducted for each limb. Results Significant main effects of step frequency were found in multiple parameters (P < 0.01). Both peak GRF and GRF impulse parameters that demonstrated significant main effects tended towards decreasing magnitude with increasing step frequency. Peak vertical GRF in particular demonstrated the most symmetric values between the limbs from − 5% to 0% metronome frequency. All parameters that demonstrated significant effects in asymmetry ratio became more asymmetric with increasing step frequency. Conclusions For runners with a unilateral transfemoral amputation, increasing step frequency is a viable method to decrease the magnitude of GRFs. However, with the increase of step frequency, further asymmetry in gait is observed. The relationships between step frequency, GRFs, and the asymmetry ratio in gait may provide insight into the training of runners with unilateral transfemoral amputation for the prevention of injury.

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Effect of prosthetic alignment on gait and biomechanical loading in individuals with transfemoral amputation: A preliminary study

Cited by 20 publications

References 23 publications

Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy

Unilateral above-knee amputees achieve symmetric mediolateral ground reaction impulse in walking using an asymmetric gait strategy

Transfemoral prosthetic simulators versus amputees: ground reaction forces and spatio-temporal parameters in gait

Effects of step frequency during running on the magnitude and symmetry of ground reaction forces in individuals with a transfemoral amputation

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