Energy expenditure in people with transtibial amputation walking with crossover and energy storing prosthetic feet: A randomized within-subject study

McDonald, Cody L; Kramer, Patricia Ann; Morgan, Sara; Halsne, Elizabeth G.; Cheever, Sarah M.; Hafner, Brian J.

doi:10.1016/j.gaitpost.2018.03.040

Cited by 27 publications

(41 citation statements)

References 27 publications

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“…This outcome is comparable to two other (adult) studies which found an increase in walking speed with the XF 14 and a trend toward a reduced energy expenditure in participants who performed better on the performancebased outcomes. 16 As expected, most benefit from the XF was found in running. The mean power on the MPST improved in three of four children, indicating that they ran faster using the XF.…”

Section: Discussionsupporting

confidence: 68%

“…In a larger study of adults with a transtibial amputation (n = 27), no significant differences in energy expenditure during walking were found when using the XF compared with the ESF, although there was a trend toward a reduced energy expenditure in participants who performed better on the 6MWT, had a higher step count and had a higher Medicare Functional Classification Level at baseline. 16 Also an increase in participants' satisfaction was noted for walking, ascending stairs, running, and playing sports using the XF. 17 Although results of these studies suggest that the XF may be a promising foot for people with a transtibial amputation, and results could probably be translated to the pediatric population, additional evidence is needed to assess the potential benefits of XF relative to other feet in active children.…”

Section: Effectiveness Of a Crossover Prosthetic Foot In Active Childmentioning

confidence: 91%

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Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency

Verheul

Verschuren

Zwinkels

et al. 2020

Prosthetics &Amp; Orthotics International

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Background: Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play. Objectives: To compare children’s walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. Study Design: Pretest-posttest study. Methods: Children with lower limb amputation or deficiency were recruited. Measurements were taken at baseline with the prescribed prosthesis and 6 weeks later with the crossover foot. Walking speed, energy cost of walking, anaerobic muscle power, stair climbing speed, ankle power, and cosmesis were evaluated. Results: Four children participated in the study. Two children had increased walking speed with the same energy cost, one child had decreased speed with increased energy cost, and one child had the same speed with decreased energy cost. Muscle power increased for three of the four children and ankle power increased for all children while using the crossover foot compared to the prescribed prosthesis. Two children reported knee pain or feeling excessive knee flexion when running with the crossover foot. One child reported negative feelings toward cosmesis of the crossover foot. Conclusions: This study suggests crossover foot may benefit active children by improving walking and running performance, and decreasing energy cost. However, knee pain reports or negative feelings toward the atypical design suggest the crossover foot may not be ideal for every child. Further research is needed to determine which pediatric users would benefit from this type of prosthetic foot. Clinical relevance Children with lower limb deficiencies are active prosthetic users who often switch between low- and high-intensity movements in their daily activities. Therefore, they might benefit from a crossover prosthetic design. The preliminary findings of this study suggest the crossover foot (XF) may be a promising foot for active children.

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Section: Discussionsupporting

confidence: 68%

Section: Effectiveness Of a Crossover Prosthetic Foot In Active Childmentioning

confidence: 91%

Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency

Verheul

Verschuren

Zwinkels

et al. 2020

Prosthetics &Amp; Orthotics International

View full text Add to dashboard Cite

show abstract

“…An interdisciplinary group of engineers, orthotists, prosthetists, physical therapists and some users was conformed for the design, manufacture and validation of the product. Using physical and biomechanical measurements, and with the help of patients, this team designed several solutions to select the prototype that best biomechanically and physically reproduces the behavior of walking, regarding balance and mass center, during biped walk under reasonable conditions [4,5].…”

Section: General Analysis Of Prostheticsmentioning

confidence: 99%

Análisis biomecánico del pie protésico Bioc-dm2

et al. 2019

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Walking is one of the aspects directly compromising human wellbeing, as it has a physical and emotional impact in daily life.For this study, we delve into the challenge of improving some walking conditions in a patient suffering lower limb loss, specifically at transtibialor transfemoral levels. Given that our purpose was the analysis, design and manufacture of a lower-limb prosthetic component, which fills the needsfor functionality, it became necessary to build a foot with all the quality standards associated to each and all movements required to form thecomplex fundamental pattern of walking. Besides, this foot should also easily endure weight, daily use and physical characteristics of the patientobject of this study. When performing physical validation and during human walk, a proper response is observed in terms of mechanics, materialsand dynamics of the component, thus making evident proper construction and assembly. On the other hand, it is feasible that design and verificationof the component provided a competitive element, as compared to existing elements currently in the market. The previous situation generated theneed for verification from the National Institute for Medications and Food (INVIMA), as well as the revision of the use replying device, forcomponent verification, in accordance with ISO 10328.

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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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Energy expenditure in people with transtibial amputation walking with crossover and energy storing prosthetic feet: A randomized within-subject study

Cited by 27 publications

References 27 publications

Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency

Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency

Análisis biomecánico del pie protésico Bioc-dm2

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

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