Mechanical work adaptations of above-knee amputee ambulation

Seroussi, Richard E.; Gitter, Andrew; Czerniecki, Joseph M.; Weaver, Kelly

doi:10.1016/s0003-9993(96)90151-3

Cited by 141 publications

(132 citation statements)

References 12 publications

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“…In the last part of the stance-phase (pre-swing) the hip flexors act in the same strength as normal despite the low weight of the prosthesis (30% of the weight of a normal lower limb). This is compensatory to the diminished push-off on the prosthetic side (Seroussi et al, 1996).…”

Section: Adaptive Mechanisms In Gait With a Prosthesismentioning

confidence: 99%

“…The most important adaptation of the nonamputated side during stance-phase is the increased muscle work of the hip-extensors and the ankle-foot plantar-flexors to compensate for the decreased push-off of the prosthetic side (Seroussi et al, 1996). Due to the increased plantar flexion work in mid-stance of the nonamputated side, the body centre of mass will rise, which allows the swing-phase of the prosthesis by raising the prosthesis off the ground (vaulting).…”

Section: Adaptive Mechanisms In Gait With a Prosthesismentioning

confidence: 99%

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Gait analysis in prosthetics

Rietman

Postema

Geertzen

2002

Prosthetics &Amp; Orthotics International

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A review was performed of the literature of the last eleven years (1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000) with the topic: "clinical use of instrumented gait analysis in patients wearing a prosthesis of the lower limb". To this end a literature search was performed in Embase, Medline and Recal. Forty-five (45) articles were identified for study from which 34 were reviewed. The reviews were divided into five subtopics: 1) adaptive strategies in gait (12 studies); 2) the influence of different parts of the prosthesis on gait (12 studies); 3) pressure measurements in the socket in gait studies (4 studies); 4) the influence of the mass of the prostheses on gait (5 studies); 5) energy considerations in gait (2 studies).A considerable part of the studies concerned the adaptive strategies of the amputee in walking and running and the evaluation of different prosthetic feet. All aspects and outcomes were reviewed concerning the clinical relevance. ConclusionInstrumented gait analysis in prosthetics provides better insights and knowledge of the different adaptive mechanisms of the body in walking with a prosthesis. Most instrumented gait studies are done in a gait laboratory. This is not comparable with the patient's home or work situation. Instrumented gait studies assess only

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Section: Adaptive Mechanisms In Gait With a Prosthesismentioning

confidence: 99%

Section: Adaptive Mechanisms In Gait With a Prosthesismentioning

confidence: 99%

Gait analysis in prosthetics

Rietman

Postema

Geertzen

2002

Prosthetics &Amp; Orthotics International

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“…To date, few studies have systematically explored the nature of these control strategies, particularly during the stance phase of gait when inadequate control may lead to a sudden collapse of the knee joint and an increased risk of falling [13,14]. However, compensatory strategies at the ipsilateral hip joint and trunk have been identified as potential mechanisms by which persons with transfemoral amputation coordinate prosthetic knee flexion and extension [16][17][18][19][20][21][22][23]. Specifically, it is assumed that during early stance phase, persons with transfemoral amputation exert a hip extension moment to shift the ground reaction force (GRF) vector anterior to the knee joint center, thereby promoting knee extension for stable weight bearing.…”

Section: Introductionmentioning

confidence: 99%

The biomechanical response of persons with transfemoral amputation to variations in prosthetic knee alignment during level walking

2016

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Prosthetic alignment is an important factor in the overall fit and performance of a lower-limb prosthesis. However, the association between prosthetic alignment and control strategies used by persons with transfemoral amputation to coordinate the movement of a passive prosthetic knee is poorly understood. This study investigated the biomechanical response of persons with transfemoral amputation to systematic perturbations in knee joint alignment during a level walking task. Quantitative gait data were collected for three alignment conditions: bench alignment, 2 cm anterior knee translation (ANT), and 2 cm posterior knee translation (POST). In response to a Participation Follow-Up: The authors do not plan to inform participants of the publication of this study. However, participants have been encouraged to check the Northwestern University Prosthetics-Orthotics Center Web site for updated publications related to the program's activities, which include the present study. Disclaimer:The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the U.S. Government. U.S. Department of Veterans AffairsPublic Access Author manuscript J Rehabil Res Dev. Author manuscript; available in PMC 2017 August 17. VA Author ManuscriptVA Author Manuscript VA Author Manuscript destabilizing alignment perturbation (ANT), subjects significantly increased their early-stance hip extension moment, confirming that persons with transfemoral amputation rely on a hip extensor strategy to maintain knee joint stability. However, subjects also decreased the rate at which they loaded their prosthesis, decreased their step length, increased their trunk flexion, and maintained their limb in a more vertical posture at the time of opposite toe off. Collectively, these results suggest that persons with transfemoral amputation rely on a combination of strategies to coordinate stance-phase knee flexion. Further, no significant changes were observed in response to the POST condition, suggesting that a bias toward posterior alignment may have fewer implications in terms of stance-phase, knee-joint control.

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“…Second, although two reviewers independently searched the electronic databases, we included only articles published in English owing to a limited availability of translation services, which may have introduced publication bias. Further, during title screening of articles, we excluded articles that primarily investigated kinetics during a functional task; however, kinematic data were also presented in a few of those articles [61][62], which may have limited the number of final articles for our review. A secondary search through references of the included articles and previously published reviews [3][4] strengthened our search strategy.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

et al. 2015

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Abstract-Following amputation, people with transfemoral amputation (TFA) and transtibial amputation (TTA) adapt with asymmetrical movements in the spinal and lower-limb joints. The aim of this review is to describe the trunk, lumbopelvic, and hip joint movement asymmetries of the amputated limb of people with TFA and TTA during functional tasks as compared with the intact leg and/or referent leg of nondisabled controls. Electronic databases were searched from inception to February 2014. Studies with kinematic data comparing (1) amputated and intact leg and (2) amputated and referent leg of nondisabled controls were included (26 articles). Considerable heterogeneity in the studies precluded data pooling. During stance phase of walking in participants with TFA, there is moderate evidence for increased trunk lateral flexion toward the amputated limb as compared with the intact leg and increased anterior pelvic tilt as compared with nondisabled controls. None of the studies investigated spinal kinematics during other functional tasks such as running, ramp walking, stair climbing, or obstacle crossing in participants with TFA or TTA. Overall, persons with TFA adapt with trunk and pelvic movement asymmetries at the amputated limb to facilitate weight transfer during walking. Among participants with TTA, there is limited evidence of spinal and pelvic asymmetries during walking.

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Mechanical work adaptations of above-knee amputee ambulation

Cited by 141 publications

References 12 publications

Gait analysis in prosthetics

Gait analysis in prosthetics

The biomechanical response of persons with transfemoral amputation to variations in prosthetic knee alignment during level walking

Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review

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