Joint loading and bone mineral density in persons with unilateral, trans-tibial amputation

Royer, Todd D.; Koenig, Michael J.

doi:10.1016/j.clinbiomech.2005.07.003

Cited by 61 publications

(60 citation statements)

References 24 publications

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“…An age-matched control group (n = 9) was enrolled, as well. The proximal tibial, peak knee, internal abduction moment on the intact limb was 56 percent greater than on the prosthetic side knee, whereas in the control group's intact limb knee, it was 24 percent higher than in the prosthetic limb knee [45]. In contrast, when comparing prosthetic feet characteristics, Underwood et al reported only a 5 percent difference in internal abduction moment at the knee among people with transtibial amputation (n = 11) [46].…”

Section: Kneementioning

confidence: 84%

“…Royer and Koenig also found that BMD at the proximal tibia was 45 percent larger in the contralateral limb knee than the prosthetic limb knee. They suggested that the contralateral knee experiences greater mechanical loading than the prosthetic limb, as reflected by the increased BMD, which may predispose people with transtibial amputation to premature joint degeneration, particularly knee osteoarthritis [45,47].…”

Section: Kneementioning

confidence: 99%

“…To understand why people with amputation are predisposed to premature joint degeneration, Royer and Koenig compared the prosthetic limb with the contralateral limb to investigate frontal plane net joint moments with respect to the mechanics of gait and bone mineral density (BMD) of the proximal tibia of people with unilateral transtibial amputation (n = 9) [45]. An age-matched control group (n = 9) was enrolled, as well.…”

Section: Kneementioning

confidence: 99%

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Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use

Gailey

Allen

Castles

et al. 2008

JRRD

611

411

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Abstract-Musculoskeletal imbalances or pathologies often develop into secondary physical conditions or complications that may affect the mobility and quality of life of people with lowerlimb amputation. Using one or more prostheses causes people with amputation to alter the biomechanics of their movement. For example, people with lower-limb amputation often favor and stress their intact lower limb more during everyday activities. This can lead to degenerative changes such as osteoarthritis of the knee and/or hip joints of the intact limb. Since people with amputation spend less time on their residual limb, osteopenia and subsequent osteoporosis often occur secondary to insufficient loading through the long bones of the lower limb. A proper prosthetic fit increases the probability of equal force distribution across the intact and prosthetic limbs during ambulation, thus decreasing the risk of osteoarthritis. People with limb loss commonly complain of back pain, which is linked to poor prosthetic fit and alignment, postural changes, leg-length discrepancy, amputation level, and general deconditioning. We review the literature on secondary complications among people with lowerlimb loss who are long-term prosthesis wearers.

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Section: Kneementioning

confidence: 84%

Section: Kneementioning

confidence: 99%

Section: Kneementioning

confidence: 99%

See 1 more Smart Citation

Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use

Gailey

Allen

Castles

et al. 2008

JRRD

611

411

View full text Add to dashboard Cite

show abstract

“…During swing, where ground reaction forces are not present, the reduced inertial properties of the prosthesis are more likely to influence estimates of resultant joint moments. Given that some researchers e.g., [26][27][28][29][30][31][32] utilize intact segment inertia properties to represent prosthesis inertial properties and otherse.g. [21][22][23] estimate prosthesis inertial properties directly, it is important to understand the impact of the methods chosen for estimating the inertial properties of the prosthesis.…”

Section: Introductionmentioning

confidence: 99%

Oscillation and Reaction Board Techniques for Estimating Inertial Properties of a Below-knee Prosthesis

Smith

Ferris

Heise

et al. 2014

JoVE

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The purpose of this study was two-fold: 1) demonstrate a technique that can be used to directly estimate the inertial properties of a below-knee prosthesis, and 2) contrast the effects of the proposed technique and that of using intact limb inertial properties on joint kinetic estimates during walking in unilateral, transtibial amputees. An oscillation and reaction board system was validated and shown to be reliable when measuring inertial properties of known geometrical solids. When direct measurements of inertial properties of the prosthesis were used in inverse dynamics modeling of the lower extremity compared with inertial estimates based on an intact shank and foot, joint kinetics at the hip and knee were significantly lower during the swing phase of walking. Differences in joint kinetics during stance, however, were smaller than those observed during swing. Therefore, researchers focusing on the swing phase of walking should consider the impact of prosthesis inertia property estimates on study outcomes. For stance, either one of the two inertial models investigated in our study would likely lead to similar outcomes with an inverse dynamics assessment.

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“…Previous research has looked at amputation jump takeoff characteristics [17][18][19] but no research has looked at the landing phase of the jump. Research on unilateral TTA walking and running gait has reported asymmetry where the intact limb experiences a greater loading than the prosthetic limb and/or ND persons [20][21][22]. People with amputation who are encouraged to participate in physical activity may therefore be compromised because of possible bilateral strength differences and their predisposition to OA at the intact knee and hip [17].…”

Section: Introductionmentioning

confidence: 99%

Asymmetrical loading demands associated with vertical jump landings in people with unilateral transtibial amputation

2013

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Abstract-Loading symmetry during vertical jump landings between a person with amputation's intact and prosthetic limbs was assessed to determine the role of each limb in controlling the downward momentum of the center of mass during landing. Six participants with unilateral transtibial amputation (TTA) and ten nondisabled participants completed 10 maximal vertical jumps, of which the highest jump was analyzed. Contralateral symmetry was assessed through the Symmetry Index (SI), while symmetry at the group level was assessed through a Mann-Whitney U test. Participants with TTA performed quasiunilateral landings onto the intact limbs, resulting from either the incapability of the prosthetic ankle to plantar flex or increased residual-limb knee and hip flexion. In the loading phase, the participants with TTA displayed reduced prostheticside peak vertical forces (p = 0.04) along with reduced prosthetic-side ankle range of motion (p < 0.001), extensor moments (p = 0.03), and negative work generated (p = 0.00). Individual asymmetries were evident in the peak vertical force magnitudes (SI = 51%-140%), duration from touchdown to peak vertical force (SI = 52%-157%), ankle joint angles at touchdown (SI = 100%-538%), ranges of motion (SI = 147%-200%), knee (SI = 66%-179%) and hip (SI = 87%-132%) extensor moments, and work done at the ankle (SI = 155%-199%) and hip (SI = 83%-204%

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Joint loading and bone mineral density in persons with unilateral, trans-tibial amputation

Cited by 61 publications

References 24 publications

Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use

Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use

Oscillation and Reaction Board Techniques for Estimating Inertial Properties of a Below-knee Prosthesis

Asymmetrical loading demands associated with vertical jump landings in people with unilateral transtibial amputation

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