Gait asymmetry of transfemoral amputees using mechanical and microprocessor-controlled prosthetic knees

Kaufman, Kenton R.; Frittoli, S.; Frigo, C.

doi:10.1016/j.clinbiomech.2011.11.011

Cited by 148 publications

(129 citation statements)

References 31 publications

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“…This low flexion in the stance phase is probably caused by patients' attempts to retain stability in the support phase in the affected limb. This conclusion is in accordance with other studies which described inadequate flexion in patients with various types of prosthetic knee joints (Johansson et al, 2005;Kaufman et al, 2012;Segal et al, 2006). In both groups of amputees there is higher maximum flexion of the hip joint during the swing phase for the intact limb in comparison with control group.…”

Section: Discussionsupporting

confidence: 82%

“…These differences were also found in studies by Kaufman et al (2012) and Johansson et al (2005). This difference causes a high degree of asymmetry between the two sides in terms of the hip joint angle during heel contact.…”

Section: Discussionsupporting

confidence: 57%

“…However, in some studies subjects moved at their own natural speed, which was different in many cases, and in other studies subjects had a short time to become accustomed to the new type of prosthetic knee design (Johansson et al, 2005;Kaufman et al, 2012;Mâaref et al, 2010). In our study all subjects walked at identical range of speed to reduce the effect of potentially confounding variables (Nolan et al, 2003;Schaarschmidt, Lipfert, Meier-Gratz, Scholle, & Seyfarth, 2012;Stoquart, Detrembleur, & Lejeune, 2008) and all patients had been using a prosthetic knee joint for two or more years.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies compared kinematics of gait among transfemoral amputees wearing different types of prosthetic knee joint (Bellmann, Schmalz, & Blumentritt, 2010;Johansson, Sherrill, Riley, Bonato, & Herr, 2005;Kaufman, Frittoli, & Frigo, 2012;Mâaref et al, 2010;Segal et al, 2006). However, in some studies subjects moved at their own natural speed, which was different in many cases, and in other studies subjects had a short time to become accustomed to the new type of prosthetic knee design (Johansson et al, 2005;Kaufman et al, 2012;Mâaref et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Kinematics of gait using bionic and hydraulic knee joints in transfemoral amputees

Uchytil¹,

Jandacka²,

Farana³

et al. 2017

Acta Gymnica

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Kinematics of gait using bionic and hydraulic knee joints in transfemoral amputees

Uchytil¹,

Jandacka²,

Farana³

et al. 2017

Acta Gymnica

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“…Onset of GA can also follow acute events such as stroke [6] and amputation [7]. Thus, quantification of GA has become central to the clinical monitoring and treatment of many chronic and acute neurological and musculoskeletal diseases [8][9].…”

Section: -Introductionmentioning

confidence: 99%

Validity and sensitivity of the longitudinal asymmetry index to detect gait asymmetry using Microsoft Kinect data

et al. 2017

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Research highlights:-The Continuous Relative Phase is not useable with Kinect.-New longitudinal index Ilong is sensitive and validated to detect gait asymmetry.-The Ilong index works with Kinect placed either in front of or behind subjects.-Only few strides (at least 5) are needed to compute a valid Ilong. AbstractGait asymmetry information is a key point in disease screening and follow-up. Constant Relative Phase (CRP) has been used to quantify within-stride asymmetry index, which requires noise-free and accurate motion capture, which is difficult to obtain in clinical settings. This study explores a new index, the Longitudinal Asymmetry Index (ILong) which is derived using data from a low-cost depth camera (Kinect). ILong is based on depth images averaged over several gait cycles, rather than derived joint positions or angles. This study aims to evaluate 1) the validity of CRP computed with Kinect, 2) the validity and sensitivity of ILong for measuring gait asymmetry based solely on data provided by a depth camera, 3) the clinical applicability of a posteriorly mounted camera system to avoid occlusion caused by the standard front-fitted treadmill consoles and 4) the number of strides needed to reliably calculate ILong. The gait of 15 subjects was recorded concurrently with a markerbased system (MBS) and Kinect, and asymmetry was artificially reproduced by introducing a 5cm sole attached to one foot. CRP computed with Kinect was not reliable. ILong detected this disturbed gait reliably and could be computed from a posteriorly placed Kinect without loss of validity. A minimum of five strides was needed to achieve a correlation coefficient of 0.9 between standard MBS and low-cost depth camera based ILong. ILong provides a clinically pragmatic method for measuring gait asymmetry, with application for improved patient care through enhanced disease, screening, diagnosis and monitoring.Keywords: Kinect; Gait analysis; gait asymmetry; sensitivity analysis; CRP. Gait asymmetry is typically evaluated using kinematic data and spatio-temporal gait parameters (step/ stride length and duration). Based on these global variables, indicators have been introduced to quantify asymmetry, including the Symmetry Ratio [6] and Symmetry Index [6]. These indicators provide global asymmetry information for a studied gait cycle, but cannot be used to analyse how asymmetry occurs at specific instances within the gait cycle.To overcome this limitation, some authors have proposed analysis of the Constant Relative Phase (CRP) and its derivatives [10]. For a given joint, this indicator constructs a phase diagram based on angular value and angular velocity. Gait asymmetry can be assessed by comparing the CRP of the corresponding left and right joints. It has been used to measure asymmetry caused by weights placed on one foot [11] and pathologies such as stroke [12].However, CRP is based on sagittal joint angles and their derivatives, which impose the use of accurate and noise-free motion capture systems, such as optoelectronic systems [11,12]...

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Knee extensor power predicts six‐minute walk test performance in people with transfemoral amputations

Slater

Finucane

Hargrove

2021

PM&R

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Background: Lower-limb amputees have increased metabolic costs during walking that may be mitigated by maintaining quadriceps strength and power following amputation. However, there are no current studies investigating the relationship between thigh strength and walking performance in individuals with transfemoral amputation. Objective: To quantify the relationship between intact limb quadriceps strength in transfemoral amputees and six-minute walk test (6MWT) performance. Design: Descriptive laboratory study. Setting: Laboratory. Participants: Eleven participants with unilateral transfemoral amputations from trauma or osteosarcoma (4 women/7 men, 46.21 AE 12.68 years old, 28.24 AE 20.57 years following amputation). Interventions: Strength and power testing on the intact limb followed by 6MWT with a flowmeter to measure oxygen uptake (VO 2 ). Main Outcome Measures: Strength included mass-normalized peak torque, average torque, and average power. 6MWT measures included total distance traveled and VO 2 normalized to distance and mass. Significant correlations (P ≤ .05) were retained for a regression analysis. Results: Peak isokinetic knee extensor torque was correlated with total VO 2 (r = À.60, P = .05) and distance traveled (r = .84, P = .001). Average isokinetic knee extensor torque was correlated with total VO 2 (r = À.61, P = .046) and distance traveled (r = .85, P = .001). Average knee extensor power was correlated with total VO 2 (r = À.67, P = .026) and distance traveled (r = .88, P < .001). Peak isometric knee extensor torque was correlated with distance traveled (r = .69, P = .019). Average power explained 77.2% of the variance in distance traveled during the 6MWT (P < .001) and average power explained 44.2% of the variance in total VO 2 during the 6MWT (P = .026). Conclusions: Knee extensor strength was correlated with performance on the 6MWT in individuals with unilateral transfemoral amputation. The strongest relationship was between isokinetic quadriceps power and distance traveled, which suggests that developing quadriceps power in the intact limb following amputation may be an important factor to reduce metabolic cost of walking and support a return to an active lifestyle.

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Gait asymmetry of transfemoral amputees using mechanical and microprocessor-controlled prosthetic knees

Cited by 148 publications

References 31 publications

Kinematics of gait using bionic and hydraulic knee joints in transfemoral amputees

Kinematics of gait using bionic and hydraulic knee joints in transfemoral amputees

Validity and sensitivity of the longitudinal asymmetry index to detect gait asymmetry using Microsoft Kinect data

Knee extensor power predicts six‐minute walk test performance in people with transfemoral amputations

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