Mass and mass distribution of below-knee prostheses: Effect on gait efficacy and self-selected walking speed

Lehmann, Justus F.; Price, Robert; Okumura, Ramona; Questad, Kent A.; Lateur, Barbara J. de; Négretot, Alain

doi:10.1016/s0003-9993(98)90293-3

Cited by 44 publications

(42 citation statements)

References 13 publications

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“…However, this explanation seems unlikely; while the 9 mm liner was approximately 2.15 times heavier than the 3 mm liner, the difference in mass was only about 0.341 kg. Lehmann et al investigated the effect of adding mass to transtibial prostheses and showed that when mass was added to the proximal end of the prosthesis (as was the case with the thicker liner), energy expenditure for level walking was not significantly affected [28]. The average difference in mass during Lehmann et al's study was approximately 1.5 kg, compared with the 0.341 kg found in this study.…”

Section: Discussionmentioning

confidence: 49%

Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket

Boutwell¹,

Stine²,

Hansen

et al. 2012

JRRD

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Abstract-Prosthetic gel liners are often prescribed for persons with lower-limb amputations to make the prosthetic socket more comfortable. However, their effects on residual limb pressures and gait characteristics have not been thoroughly explored. This study investigated the effects of gel liner thickness on peak socket pressures and gait patterns of persons with unilateral transtibial amputations. Pressure and quantitative gait data were acquired while subjects walked on liners of two different uniform thicknesses. Fibular head peak pressures were reduced (p = 0.04) with the thicker liner by an average of 26 +/-21%, while the vertical ground reaction force (GRF) loading peak increased 3 +/-3% (p = 0.02). Most subjects perceived increased comfort within the prosthetic socket with the thicker liner, which may be associated with the reduced fibular head peak pressures. Additionally, while the thicker liner presumably increased comfort by providing a more compliant limb-socket interface, the higher compliance may have reduced force and vibration feedback to the residual limb and contributed to the larger vertical GRF loading peaks. We conclude that determining optimal gel liner thickness for a particular individual will require further investigations to better identify and understand the compromises that occur between user perception, residuallimb pressure distribution, and gait biomechanics.

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Section: Discussionmentioning

confidence: 49%

Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket

Boutwell¹,

Stine²,

Hansen

et al. 2012

JRRD

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“…12,13,34,40,51,52 These studies show a large variation in the amount and location of mass added to the prosthesis. Mass added to prostheses ranged from 50 g 34 to 2 kg 51 .…”

Section: Independent Variablesmentioning

confidence: 97%

Motion-analysis studies of transtibial prosthesis users

Rusaw

Ramstrand

2011

Prosthetics &Amp; Orthotics International

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Background: Three-dimensional motion analysis has been used since the beginning of the 1980s to evaluate many aspects of physical function of transtibial amputees. Despite its common use for clinical research, there is large variability in methods of capturing three-dimensional data, description of these methods, reporting of joint kinematics and interpretation of research findings. Objectives: The aim of the following review is to critically examine the specific methodologies used by researchers when collecting three-dimensional kinematic data on transtibial amputees and to provide an overview of the methods used. Study design: Systematic review. Methods: A systematic review of the literature between January 1984 and June 2009 was conducted. A total of 68 papers were identified for review based on the following criteria: experimental research design, collection of three-dimensional kinematic data of lower-extremity joints, and inclusion of transtibial amputees as experimental subjects. Results: A number of methodological shortcomings were identified in the papers reviewed. Conclusions: The authors recommend that future studies more appropriately address the product name and number of prosthetic components used; how the position of reflective markers on the prosthesis is defined; presentation of data from both sound and affected sides; and definition of the neutral position of the ankle when reporting kinematic data. Where possible, the authors recommend use of a control group. Clinical relevanceThis paper has identified numerous sources of discrepancy and potential error in kinematic data collected on trans-tibial amputees. Clinicians and researchers should make themselves aware of these issues when collecting and interpreting gait data.

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“…Four papers were classified "A-level studies" [17,18,67,68], twenty-six "B-level studies" [2,3,13,16,20,22,23,27,30,36,37,42,[44][45][46][55][56][57][58]61,66,69,71,77,81,83], whereas ten studies were classified "C-level studies" [1,15,35,39,[52][53][54]59,63,76]. The main difference between the A-and B-level studies was a negative score on the "blinded assessment" (criterion B7).…”

Section: Selection Of Studiesmentioning

confidence: 99%

“…In eight studies on prosthetic mass [35,39,[52][53][54]59,63,76] and the Board's study on prosthetic socket design [15], the subjects were not allowed sufficient time to adapt to the intervention, so they received a negative B8 score. Eight studies did not indicate possible dropouts [1,3,16,30,52,53,76,81].…”

Section: Selection Of Studiesmentioning

confidence: 99%

A systematic literature review of the effect of different prosthetic components on human functioning with a lower-limb prosthesis

Linde

Hofstad²,

Postema³

et al. 2004

JRRD

158

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Abstract-A correct prosthetic prescription can be derived from adapting the functional benefits of a prosthesis to the functional needs of the prosthetic user. For adequate matching, the functional abilities of the amputees are of value, as well as the technical and functional aspects of the various prosthetic components. No clear clinical consensus seems to be given on the precise prescription criteria. To obtain information about different prosthetic components and daily functioning of amputees with a prosthesis, we performed a systematic literature search. The quality of the studies was assessed with the use of predetermined methodological criteria. Out of 356 potentially relevant studies, 40 studies eventually qualified for final methodological analysis and review. Four satisfied all the criteria and were classified as A-level studies, 26 as B-level, and 10 studies as C-level studies. Despite a huge amount of literature, our formal clinical knowledge had considerable gaps concerning the effects of different prosthetic components and their mechanical characteristics on human functioning with a lowerlimb prosthesis. Therefore, with regard to prosthetic guideline development, we must still largely rely on clinical consensus among experts. The integration of knowledge from research with the expert opinion of clinical professionals and the opinions and wishes of consumers can form a solid base for a procedure on guideline development for prosthetic prescription.

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Mass and mass distribution of below-knee prostheses: Effect on gait efficacy and self-selected walking speed

Cited by 44 publications

References 13 publications

Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket

Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket

Motion-analysis studies of transtibial prosthesis users

A systematic literature review of the effect of different prosthetic components on human functioning with a lower-limb prosthesis

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