Transition from Sitting to Standing after Trans-Femoral Amputation

Abstract

Standing up is an important and common daily activity. It is essential for independence and a prerequisite for walking. Many elderly and many subjects with impairments have problems with transition from sitting to standing. The aim of the present study was to determine whether there was any difference between the characteristics of standing up in trans-femoral amputees and healthy subjects. Five young trans-femoral amputees and five healthy subjects were included in the study. They were asked to stand up. The body motion was recorded using an Optotrak contactless optical system. The force and moment vectors exerted on the seat were recorded by a JR3 six-axis robot wrist sensor. The force under the feet was recorded by two AMTI force plates. The trans-femoral amputees were found to stand up more slowly than the healthy subjects. The angles of the hip, knee, and ankle joints on the amputated side were different from the angles on the healthy side or in the healthy subjects. There was also a great difference in loading between the healthy and the prosthetic foot. It can be concluded that there are differences in standing up between the trans-femoral amputees and the healthy subjects. These differences may indicate a reason for problems many elderly trans-femoral amputees face when standing up.

Kinetic asymmetry in transfemoral amputees while performing sit to stand and stand to sit movements

“…Subjects in these studies took a mean duration to stand up of 1.8 (Kuzelicki et al) and 2.6 (Burger et al) s [2,3]. Cumulatively, the stand durations we observed are slightly shorter than those reported by Burger et al and more similar to those reported by Kuzelicki et al [2,3].…”

Persons with unilateral transfemoral amputation have altered lumbosacral kinetics during sitting and standing movements

“…Larger peak lateral trunk lean and overall range of motion observed here is consistent with other patient populations, such as Parkinson's Disease [19] or hemiparesis [22]. Similarly, transverse trunk rotations were larger with transfemoral amputation, with the largest rotations again occurring toward the intact limb [15,23]. In contrast, uninjured controls had minimal lateral and transverse trunk motion, and small joint moments and powers in the frontal and transverse planes.…”

“…These individuals consistently demonstrate weight bearing asymmetries among the lower extremities, with higher loads in the unaffected limb. Persons with unilateral LLA also tend to rely more upon their intact limb during gait [13], and lower-extremity kinetic asymmetries have been observed during sit-to-stand movements [14][15][16]. Yet, despite the upper body's substantial proportion of total body mass Increases in spinal loading have been related to altered movements of the lower back during gait among persons with lower limb amputation, movements which are self-perceived by these individuals as contributing factors in the development of low back pain.…”

Can the International Classification of Functioning, Disability and Health (ICF) be used in a prosthetics and orthotics outpatient clinic?

“…Prostheses replace an amputated part of the body and try to restore the lost body function and decrease the problems with activities and participation. [7][8][9][10][11][12][13][14] Orthoses also influence body functions, such as increased or decreased mobility, pain, decreased muscle strength and so on. 15 The result is improved functioning.…”