Transfemoral amputee intact limb loading and compensatory gait mechanics during down slope ambulation and the effect of prosthetic knee mechanisms

2018 ◽  
Vol 55 ◽  
pp. 65-72 ◽  
Author(s):  
David C. Morgenroth ◽  
Michelle Roland ◽  
Alison L. Pruziner ◽  
Joseph M. Czerniecki
Keyword(s):  
Transfemoral Amputee ◽  
Prosthetic Knee ◽  
Limb Loading ◽  
Gait Mechanics ◽  
Intact Limb

Design of a Sports Knee Prosthesis

1999 ◽  
Author(s):  
Denis J. DiAngelo ◽  
Charles E. Evans
Keyword(s):  
Energy Expenditure ◽  
Knee Flexion ◽  
Knee Prosthesis ◽  
Weight Bearing ◽  
Impact Loads ◽  
Computation Model ◽  
Prosthetic Knee ◽  
Locking Mechanism ◽  
Gait Study ◽  
Intact Limb

Abstract Typical walking prostheses maintain stability during stance with a knee locking mechanism; i.e., a frictional device (mechanical brake) or free rotating knee joint (single pinned or multi-link system) held in a hyper-extended orientation (de Vries, 1995). Attempts to jog with a walking prosthesis are difficult and unsafe. A previous gait study of a “pogo-stick” A/K jogging prosthesis found that the device provided alternating periods of support and non-support between the amputated and non-amputated sides, but required greater energy expenditure from the intact limb and induced larger impact loads (DiAngelo et al., 1989). A computer modeling technique was used to design a multi-link above-knee (A/K) prosthesis that provided continuous, controlled knee flexion during weight bearing and free knee rotation during swing. Aspects of the design were improved energy expenditure, symmetrical gait, and reduced impact loading. Biomechanical data for the computation model was obtained from a gait study of an A/K amputee jogger. The objective of the study was to develop prosthetic knee that provided continuous knee flexion throughout weight bearing and free rotation during swing.

scholarly journals Does Intact Limb Loading Differ in Servicemembers With Traumatic Lower Limb Loss?

2014 ◽  
Vol 472 (10) ◽  
pp. 3068-3075 ◽  
Author(s):  
Alison L. Pruziner ◽  
Kathryn M. Werner ◽  
Timothy J. Copple ◽  
Brad D. Hendershot ◽  
Erik J. Wolf
Keyword(s):  
Lower Limb ◽  
Limb Loss ◽  
Limb Loading ◽  
Intact Limb

scholarly journals Mechanisms to Attenuate Load in the Intact Limb of Transtibial Amputees When Performing a Unilateral Drop Landing

2020 ◽  
Vol 36 (1) ◽  
pp. 4-12
Author(s):  
Sarah C. Moudy ◽  
Neale A. Tillin ◽  
Amy R. Sibley ◽  
Siobhán Strike
Keyword(s):  
Quadriceps Strength ◽  
Joint Mechanics ◽  
Work Demand ◽  
Prosthetic Limb ◽  
Drop Landing ◽  
Limb Loading ◽  
Healthy Control ◽  
Movement Mechanics ◽  
Transtibial Amputees ◽  
Intact Limb

Individuals with unilateral transtibial amputations experience greater work demand and loading on the intact limb compared with the prosthetic limb, placing this limb at a greater risk of knee joint degenerative conditions. It is possible that increased loading on the intact side may occur due to strength deficits and joint absorption mechanics. This study investigated the intact limb mechanics utilized to attenuate load, independent of prosthetic limb contributions and requirements for forward progression, which could provide an indication of deficiencies in the intact limb. Amputee and healthy control participants completed 3 unilateral drop landings from a 30-cm drop height. Joint angles at touchdown; range of motion; coupling angles; peak powers; and negative work of the ankle, knee, and hip were extracted together with isometric quadriceps strength measures. No significant differences were found in the load or movement mechanics (P ≥ .31, g ≤ 0.42), despite deficits in isometric maximum (20%) and explosive (25%) strength (P ≤ .13, g ≥ 0.61) in the intact limb. These results demonstrate that, when the influence from the prosthetic limb and task demand are absent, and despite deficits in strength, the intact limb adopts joint mechanics similar to able-bodied controls to attenuate limb loading.

Intra-individual biomechanical effects of a non-microprocessor-controlled stance-yielding prosthetic knee during ramp descent in persons with unilateral transfemoral amputation

2018 ◽  
Vol 43 (1) ◽  
pp. 55-61 ◽  
Author(s):  
Yusuke Okita ◽  
Nobuya Yamasaki ◽  
Takashi Nakamura ◽  
Tomoki Mita ◽  
Tsutomu Kubo ◽  
...  
Keyword(s):  
Ground Reaction Force ◽  
Lower Limb ◽  
Knee Flexion ◽  
Reaction Force ◽  
Transfemoral Amputation ◽  
Contralateral Limb ◽  
Prosthetic Knee ◽  
Limb Loading ◽  
Internal Joint ◽  
Prosthetic Knees

Background: A stance-yielding mechanism for prosthetic knees may reduce lower limb loading during specific activities, but quantitative data are insufficient. Objectives: To clarify the biomechanical effect of a non-microprocessor-controlled stance-yielding mechanism on ramp descent for individuals with unilateral transfemoral amputation. Study design: Intra-subject intervention study. Methods: Seven individuals with unilateral transfemoral amputation underwent three-dimensional motion analysis of ramp descent with and without activating a stance-yielding mechanism. Regarding early-stance internal joint moment and ground reaction force, whole-group and subgroup analyses stratified by stance prosthetic knee flexion were performed to verify differences in prosthetic side and contralateral limb loading between conditions. Results: Whole-group analysis revealed significant reduction in early-stance prosthetic knee extension moment with stance-yielding mechanism activation. Changes in prosthetic side hip extension moment and contralateral limb loading were inconsistent between conditions. Subjects with prosthetic stance knee flexion walked slower with a smaller stride and greater increase in aft ground reaction force and ankle dorsiflexion moment when stance-yielding was activated. Conclusion: Stance-yielding mechanism has a biomechanical potential to decrease excessive knee hyperextension. However, prosthetic side stance knee flexion induced by the stance-yielding mechanism might not necessarily reduce the mechanical load on residual hip or contralateral lower limb joints. Clinical relevance This study showed individual variability in the possibility of reducing the load on the remaining lower limb when using a non-microprocessor-controlled stance-yielding knee. This suggests that individualized prosthetic management and monitoring the activities of individuals wearing a stance-yielding prosthetic knee are crucial to maximize the benefits of stance-yielding prosthetic knees.

The functional demands on the intact limb during walking for active transfemoral and transtibial amputees

2000 ◽  
Vol 24 (2) ◽  
pp. 117-125 ◽  
Author(s):  
L. Nolan ◽  
A. Lees
Keyword(s):  
Power Generation ◽  
Sagittal Plane ◽  
Video Camera ◽  
Joint Moments ◽  
Power Absorption ◽  
Prosthetic Limbs ◽  
Prosthesis Fitting ◽  
Limb Loading ◽  
Intact Limb

The aim of this study was to investigate the loading demands placed on the intact limb in terms of joint moments and power for active transfemoral and transtibial amputees in comparison to a group of ablebodied subjects. Four (4) transtibial, 4 transfemoral amputees and 10 ablebodied subjects walked at 1.2m.s1along a walkway whilst kinematic data from both the intact and prosthetic limbs, and kinetic data from the intact limb only were collected. A Panasonic VHS video camera was used to film subjects walking in the sagittal plane with simultaneous force data collected from a Kistler force platform. The amputees were found to compensate for the functional loss of one or more joints by increasing net joint moments and power output on their intact limb compared to ablebodied subjects. At the intact limb ankle, the range of motion, peak dorsiflexor moment and power generation at toeoff increased. At the intact limb knee, power generation during stance and extensor moments and power absorption at toeoff increased. At the intact limb hip, extensor moment and power absorption during stance, and hip flexor moment and power generation at toeoff increased. These findings were partly attributed to the prostheses used but mainly to adaptation mechanisms displayed by transfemoral and transtibial amputees. They have implications for the mobility of amputees and the long term health of their joints. It was recommended that prosthesis design, prosthesis fitting and training in the use of the prosthesis were all factors which could be investigated with a view to minimising intact limb loading.

scholarly journals Classification of standing and sitting phases based on in-socket piezoelectric sensors in a transfemoral amputee

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Tawfik Yahya ◽  
Nur Azah Hamzaid ◽  
Sadeeq Ali ◽  
Farahiyah Jasni ◽  
Hanie Nadia Shasmin
Keyword(s):  
Time Domain ◽  
Classification Accuracy ◽  
Sensory System ◽  
Metabolic Energy ◽  
Support Vector ◽  
Data Set ◽  
Transfemoral Amputee ◽  
Sit To Stand ◽  
Optimal Classifier ◽  
The Impact

AbstractA transfemoral prosthesis is required to assist amputees to perform the activity of daily living (ADL). The passive prosthesis has some drawbacks such as utilization of high metabolic energy. In contrast, the active prosthesis consumes less metabolic energy and offers better performance. However, the recent active prosthesis uses surface electromyography as its sensory system which has weak signals with microvolt-level intensity and requires a lot of computation to extract features. This paper focuses on recognizing different phases of sitting and standing of a transfemoral amputee using in-socket piezoelectric-based sensors. 15 piezoelectric film sensors were embedded in the inner socket wall adjacent to the most active regions of the agonist and antagonist knee extensor and flexor muscles, i. e. region with the highest level of muscle contractions of the quadriceps and hamstring. A male transfemoral amputee wore the instrumented socket and was instructed to perform several sitting and standing phases using an armless chair. Data was collected from the 15 embedded sensors and went through signal conditioning circuits. The overlapping analysis window technique was used to segment the data using different window lengths. Fifteen time-domain and frequency-domain features were extracted and new feature sets were obtained based on the feature performance. Eight of the common pattern recognition multiclass classifiers were evaluated and compared. Regression analysis was used to investigate the impact of the number of features and the window lengths on the classifiers’ accuracies, and Analysis of Variance (ANOVA) was used to test significant differences in the classifiers’ performances. The classification accuracy was calculated using k-fold cross-validation method, and 20% of the data set was held out for testing the optimal classifier. The results showed that the feature set (FS-5) consisting of the root mean square (RMS) and the number of peaks (NP) achieved the highest classification accuracy in five classifiers. Support vector machine (SVM) with cubic kernel proved to be the optimal classifier, and it achieved a classification accuracy of 98.33 % using the test data set. Obtaining high classification accuracy using only two time-domain features would significantly reduce the processing time of controlling a prosthesis and eliminate substantial delay. The proposed in-socket sensors used to detect sit-to-stand and stand-to-sit movements could be further integrated with an active knee joint actuation system to produce powered assistance during energy-demanding activities such as sit-to-stand and stair climbing. In future, the system could also be used to accurately predict the intended movement based on their residual limb’s muscle and mechanical behaviour as detected by the in-socket sensory system.

scholarly journals Experimental study of sit-to-stand kinematics in healthy, osteoarthritic and prosthetic knee

2020 ◽  
Vol 997 ◽  
pp. 012092
Author(s):  
D Tarnita ◽  
A Petcu ◽  
V Ontica ◽  
D Prunoiu Diana ◽  
D N Tarnita
Keyword(s):  
Experimental Study ◽  
Prosthetic Knee ◽  
Sit To Stand
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