Energy expenditure and biomechanical characteristics of lower limb amputee gait:

Schmalz, Thomas; Blumentritt, Siegmar; Jarasch, Rolf

doi:10.1016/s0966-6362(02)00008-5

Cited by 332 publications

(128 citation statements)

References 15 publications

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“…We required the studies to contain metabolic cost of walking data, either per minute or per meter. After the application of the four additional criteria, we identified nine articles [3,4,[12][13][14][15][16][17][18]] from Hofstad et al's [19] systematic review that contained the necessary data for our meta-analysis. In addition, we identified only one article (Mengelkoch et al [6]) published after the systematic review that contained the relevant data and met the necessary selection criteria for the normalization method.…”

Section: Methodsmentioning

confidence: 99%

“…Some articles have found a statistically significant, albeit small, improvement in COT with ESR versus SACH feet [12][13]. Most studies, however, have failed to demonstrate any statistically significant differences [3,4,6,[14][15][16][17][18]. In the most recent systematic review of the literature, Hofstad et al's Cochrane review found "a small trend towards the Flex-foot (a type of ESR foot) in comparison with the SACH foot for .…”

Section: Introductionmentioning

confidence: 99%

“…Compared with that of nondisabled subjects, the gait of individuals with amputation is more costly per minute and per meter [3][4][5][6]; the latter often referred to as cost of transport (COT). Furthermore, the higher up the leg the amputation, the higher the COT becomes [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, we analyzed the data to see whether there was a relationship with walking speed since it is thought that ESR feet may be more effective at higher speeds [3,12].…”

Section: Introductionmentioning

confidence: 99%

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Transtibial amputee gait efficiency: Energy storage and return versus solid ankle cushioned heel prosthetic feet

Gardiner¹,

Bari

Howard³

et al. 2016

J Rehabil Res Dev

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Abstract-Energy storage and return (ESR) feet have long been assumed to promote metabolically efficient amputee gait. However, despite being prescribed for approximately 30 yr, there is limited evidence that they achieve this desired function. Here, we report a meta-analysis of data from 10 studies that met our selection criteria to determine whether amputee walking with ESR feet is more efficient than with conventional solid ankle cushioned heel (SACH) feet. Additionally, the data were tested for a relationship with walking speed since it has been suggested ESR feet might perform better at higher speeds. The raw data were highly variable because of differences in study protocols; therefore, we normalized the data and found a statistically significant difference (p < 0.001) between ESR and SACH feet. However, the magnitude of this difference is small, with the cost of transport (COT) with ESR feet being 97.3% of the cost with SACH feet. No relationship between normalized ESR COT and speed was found (p = 0.19). We hypothesize that the small but statistically significant difference between ESR and SACH feet may not constitute a functionally significant improvement in COT, possibly related to the limited push-off power provided by ESR feet compared with nondisabled ankles.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Additionally, we analyzed the data to see whether there was a relationship with walking speed since it is thought that ESR feet may be more effective at higher speeds [3,12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Transtibial amputee gait efficiency: Energy storage and return versus solid ankle cushioned heel prosthetic feet

Gardiner¹,

Bari

Howard³

et al. 2016

J Rehabil Res Dev

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show abstract

“…Models of metabolical energy expenditure can, therefore, improve the understanding of human locomotion and help on the design of therapies and assistance devices, e.g. Schmalz et al [2].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity Analysis of Human Leg Metabolical Costs

Ackermann

Schiehlen

2005

Proc Appl Math and Mech

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The human walking is characterized by skeletal dynamics and muscle excitation patterns minimizing the metabolical energy. This criterion is applied to assess the performance of lower limb prosthetic devices, and to evaluate therapies for patients presenting gait disorders. It is desirable, therefore, to dispose models of the human normal and pathological gaits capable of estimating the metabolical energy expenditure.For the swing phase of normal and pathological gaits a musculoskeletal model of the lower limb is presented to estimate metabolical energy expenditure. The mechanical model has three degrees of freedom and is actuated by eight Hill-type muscle units, and the model for the metabolical costs is adopted from literature. In this paper a combination of inverse and direct dynamics is used, and a sensitivity analysis of the dynamical behavior and the corresponding metabolical costs estimations with respect to parametrized neural excitations is performed. The leg motions are based on experiments in a gait analysis laboratory.

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Prescription of prosthetic ankle-foot mechanisms after lower limb amputation

Hofstad

Linde

Limbeek

et al. 2004

Cochrane Database of Systematic Reviews

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There is insufficient evidence from high quality comparative studies for the overall superiority of any individual type of prosthetic ankle-foot mechanism. In high activity transfemoral amputees, there is limited evidence for the superiority of the Flex foot during level walking compared with the SACH foot in respect of energy cost and, gait efficiency. This benefit has only been confirmed in transtibial amputees during decline and incline walking and increased walking speeds. In prescribing prosthetic-ankle foot mechanisms for lower-limb amputees, practitioners should take into account availability, patient functional needs, and cost.

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Energy expenditure and biomechanical characteristics of lower limb amputee gait:

Cited by 332 publications

References 15 publications

Transtibial amputee gait efficiency: Energy storage and return versus solid ankle cushioned heel prosthetic feet

Transtibial amputee gait efficiency: Energy storage and return versus solid ankle cushioned heel prosthetic feet

Sensitivity Analysis of Human Leg Metabolical Costs

Prescription of prosthetic ankle-foot mechanisms after lower limb amputation

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