Does the socket design affect symmetry and spatiotemporal gait parameters? A case series of two transfemoral amputees

Introduction: Parkinson’s disease is a progressive and degenerative pathology that causes several motor impairments in gait. Aquatic physiotherapy has become an alternative, as it allows the training of gait, balance and muscle relaxation in a safe environment due to the physical properties of water. Objective: to verify the main effects of aquatic physiotherapy on gait rehabilitation in patients with Parkinson’s disease. Study design: This is a systematic review. Methodology: The research was carried out in four distinct stages. Being carried out in the following databases EBSCO, Pubmed, PEDro, Science Direct and MEDLINE; obeying the following inclusion criteria: individuals diagnosed with idiopathic Parkinson’s disease; who underwent aquatic physiotherapy with or without a control group and the main outcome was the improvement in gait performance. Case studies, case series, monograph, dissertation and articles without full access were excluded. The following keywords were used in the research field (“hydrotherapy” OR “aquatic exercise OR aquatic therapy”) AND Parkinson’s disease AND Gait. Results: Ten articles with good to regular methodological quality were included. Most of the results of the study were functional mobility, balance, pathology progression and gait parameters. Conclusion: it was observed that aquatic physiotherapy promoted good results in gait performance, mainly in balance, functional mobility and decreased motor signals, however there is still evidence about gait parameters.

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The cost of major lower limb amputation: a 12-year experience

Prosthetics and Orthotics International ◽

10.1177/0309364612441489 ◽

2012 ◽

Vol 36 (4) ◽

pp. 430-434 ◽

Cited By ~ 21

Author(s):

Robert Warner Jordan ◽

Avi Marks ◽

Daniel Higman

Keyword(s):

Average Length ◽

Case Series ◽

Limb Amputation ◽

Valuable Insight ◽

Retrospective Case ◽

Perioperative Mortality ◽

Initial Procedure ◽

Transfemoral Amputees ◽

Critical Ischaemia ◽

The Cost

Background:The amputee population is elderly, has significant medical co-morbidities and perioperative mortality leading to high financial implications. Commonly used outcomes in the literature are survival, prosthetic use and mobility.Objectives:Our study aims to share our 12-year experience of amputee care, concentrating on perioperative mortality and patient rehabilitation.Study Design:Observational study in the form of a retrospective case series.Methods:In total, 130 amputations, performed between January 1998 and December 2009, were followed up for a mean of three and a half years and analyzed for demographics, vascular history, operation details, prosthetic use, mobility and mortality.Results:The population was 59.2% male, had a mean age of 73 and the most common indication for amputation was critical ischaemia (78.5%). The average length of acute inpatient stay was 63 days with a 30-day mortality rate of 15.3% and inpatient mortality of 29.3%. In total, 63.3% of patients were issued with a prosthesis with 48.2% of all patients achieving at least indoor mobility, transtibial (49.9%) rehabilitated better than transfemoral amputees (24.3%).Conclusions:Our data support the urgent need for action to improve perioperative mortality in the amputee population, with the added advantage of reducing its financial impact.Clinical relevanceOur study gives an overview of the clinical journey taken by a 12-year amputee population. By following this cohort from initial procedure through to rehabilitation or mortality we provide the reader with a valuable insight into the difficulties of managing this population and the likely outcomes for these patients.

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THE HYBRID SUBISCHIAL SOCKET FOR PERSONS WITH TRANSFEMORAL AMPUTATION: GAIT PARAMETERS AND CLINICAL ASSESSMENT OF A CASE SERIES

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v4i1.36252 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Roberto Pellegrini ◽

Gabriele Denza ◽

Stefano Brunelli ◽

Daniele Zenardi ◽

Matteo Imperio ◽

...

Keyword(s):

Range Of Motion ◽

Clinical Assessment ◽

Case Series ◽

Ischial Tuberosity ◽

Suspension System ◽

Test Time ◽

Transfemoral Amputation ◽

Timed Up And Go ◽

Gait Parameters ◽

Hip Range Of Motion

BACKGROUND: The subischial socket interface design is a promising new shape of socket for persons with transfemoral amputation. Typically, the proximal trim line is located distal to the ischial tuberosity, improving comfort in prosthetic users without interfering with gait parameters compared to Ischial Containment Socket (ICS). No studies have investigated the performances of a subischial sockets with suction suspension system. A new subischial socket (Hybrid Subischial Socket - HySS) combined with a hypobaric passive suspension system has been recently developed. OBJECTIVE: To assess the effects of HySS in terms of comfort, hip range-of-motion and gait parameters. METHODOLOGY: Three persons with transfemoral amputation were tested first using their usual ICS and then after one month of continuous use of HySS. FINDINGS: The following parameters improved in all participants using HySS: 1) hip range-of-motion, 2) walking speed and distance, 3) Timed-Up-and-Go-Test time, 4) stride length, 5) double support duration, 6) peak value of hip extension during stance, 7) satisfaction with the prosthesis. CONCLUSION: These findings suggest that the use of HySS could allow improvements for prosthetic use. Layman’s Abstract This case series describes the effects of a subischial socket combined with a hypobaric suction suspension system for persons with transfemoral amputation. This socket has the proximal trim line located distally to the ischial tuberosity and it does not interact with the pelvis. The results have shown that this socket may improve the overall prosthetic comfort, hip range of motion and some gait parameters compared to the conventional ischial containment socket. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36252/28095 How To Cite: Pellegrini R, Denza G, Brunelli S, Zenardi D, Imperio M, Vannozzi G, Traballesi M. The hybrid subischial socket for persons with transfemoral amputation: gait parameters and clinical assessment of a case series. Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.9. https://doi.org/10.33137/cpoj.v4i1.36252 Corresponding Author: Stefano Brunelli, MDFondazione Santa Lucia, Scientific Institute for Research, Hospitalization and Health Care, Rome, Italy.E-Mail: [email protected] ID: https://orcid.org/0000-0002-5986-1564

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Counteracting Balance Loss in Transfemoral Amputees by Using an Active Pelvis Orthosis: A Case Series

8th European Medical and Biological Engineering Conference - IFMBE Proceedings ◽

10.1007/978-3-030-64610-3_35 ◽

2020 ◽

pp. 294-305

Author(s):

Monaco Vito ◽

Aprigliano Federica ◽

Arnetoli Gabriele ◽

Doronzio Stefano ◽

Giffone Antonella ◽

...

Keyword(s):

Case Series ◽

Transfemoral Amputees ◽

Balance Loss

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The Effect of Physical Activity on Residual Limb Volume, Comfort, and Gait Symmetry of Transfemoral Amputees

Journal of Engineering and Science in Medical Diagnostics and Therapy ◽

10.1115/1.4049524 ◽

2021 ◽

Vol 4 (2) ◽

Author(s):

Sara Salazar-Salgado ◽

Fanny Valencia ◽

Alejandro Uribe ◽

Elizabeth Rendón-Vélez

Keyword(s):

Physical Activity ◽

Treadmill Walking ◽

Residual Limb ◽

Gait Symmetry ◽

Symmetry Index ◽

Ankle Kinematics ◽

Gait Parameters ◽

Significant Difference ◽

Transfemoral Amputees ◽

Almost All

Abstract For lower limb amputees, the socket fit is affected by the physical activity performed during the day. The majority of the studies in this field include only transtibial amputees and do not examine the effects of this variable. This paper aims to determine the effect of physical activity on the volume of the residual limb (RL), the comfort, and the symmetry of gait in traumatic transfemoral amputees. RL volume and gait data of five individuals were obtained at the first time of the day and after three sessions of treadmill walking. The ratio symmetry index of selected points of gait parameters was calculated. A short comfort test was used after each session. Data were analyzed throughout the tests within each subject, and statistical analysis was performed. After the physical activity, a tendency toward volume decrease was found on almost all subjects, although it was not significant. Transfemoral amputees may have smaller volume variations than transtibial after treadmill walking tasks. Significant difference was found on the symmetry index of “swing phase (SWP).” The values of gait symmetry were consistent with previous findings regarding transfemoral amputees. The lowest symmetry was noticed on the ankle kinematics. The comfort did not significantly change with the selected amount of physical activity. In subsequent research, it is recommended to increase the intensity or time of physical activity and/or increase the number of participants. These results can help the understanding of how the socket/RL interface behaves, which can improve the design and prescription of prosthetic components.

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Design, Development and Realisation of an Active Driven Knee-Prosthesis with Bevel Helical Gearbox

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.907.225 ◽

2014 ◽

Vol 907 ◽

pp. 225-239

Author(s):

Bernhard Budaker ◽

Alexander Verl

Keyword(s):

Development Process ◽

Knee Prosthesis ◽

Scientific Work ◽

Design Development ◽

Knee Prostheses ◽

Technical Parameters ◽

Gait Parameters ◽

Essential Components ◽

Transfemoral Amputees ◽

The Right

This paper presents the development of an active driven prosthesis for transfemoral amputees. At the beginning of the development process gait parameters are analyzed. Defined boundary conditions help to get the right technical parameters for a structured development process. During the following development process, different concepts for active driven knee prostheses are discussed. Essential components for active driven prosthesis systems are presented. The focus during the scientific work is the development of an active drive system for an active driven knee prosthesis. A first prototype of an active driven knee prosthesis is shown.

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