AN INNOVATIVE FOOT MODULE WITH EASILY ACCESSIBLE FRONTAL PLANE ADAPTATION ENHANCES THE LOCOMOTION ON UNEVEN GROUND

INTRODUCTION Real-life outdoor walking of amputees is challenged by uneven ground. Uneven ground requires either a component adaptation in the sagittal plane or in frontal plane or both. The lack of adaptability of prosthetic components requires compensational movement strategies by the user. Common energy storing and returning (ESR) feet have some basic flexibility through the carbon structure allowing for some limited adaptation in both planes. For the frontal plane the split toe feature adds some functionality. However, even with split toe the ROM is clearly limited and needs high force impact for minor adaptations. Now there is a novel foot module allowing for 10° inversion/eversion through a dedicated joint. This study investigates the hypothesis that such a foot module with easily accessible frontal plane adaptation enhances the locomotion on uneven ground. Abstract PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32029/24446 How to cite: Altenburg B, Ernst M, Schmalz T. AN INNOVATIVE FOOT MODULE WITH EASILY ACCESSIBLE FRONTAL PLANE ADAPTATION ENHANCES THE LOCOMOTION ON UNEVEN GROUND. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32029 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee. http://www.aopanet.org/

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Walking in Natural Environments as Geriatrician’s Recommendation for Fall Prevention: Preliminary Outcomes from the “Passiata Day” Model

Sustainability ◽

10.3390/su12072684 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2684 ◽

Cited By ~ 4

Author(s):

Giuseppe Battaglia ◽

Valerio Giustino ◽

Giuseppe Messina ◽

Mariangela Faraone ◽

Jessica Brusa ◽

...

Keyword(s):

Older People ◽

Exercise Intervention ◽

Sagittal Plane ◽

Frontal Plane ◽

Natural Environments ◽

Body Balance ◽

Walking Program ◽

Significant Difference ◽

Outdoor Walking ◽

Risk Of Falls

Background: The Geriatric Unit of the University of Palermo developed the “Passiata Day” model, a green exercise intervention consisting of a one-hour walk, once/week, in a city park. The purpose of this study was to assess body balance in older people who walked regularly compared to sedentary people. Methods: 106 older people (75 women and 31 men; mean age: 72.3 ± 8.2 years) without fall history were invited to participate voluntarily in this natural environment walking program. After six months, both the participants who had taken part regularly in the walk (i.e., the physical activity group (PAG; n = 72; 54 women and 18 men; mean age: 70.7 ± 7.2 years)), and who had not accepted to be included in the outdoor walking program (i.e., the sedentary group (SG; n = 34; 21 women and 13 men; mean age: 75.5 ± 9.4 years)), performed a stabilometric test with open eyes (OE) and with closed eyes (CE). Results: Our preliminary results showed significant differences between groups on the ellipse sway area both in the OE (p < 0.05) and in CE condition (p < 0.01). Moreover, we found a significant difference on sway along the frontal plane both in the OE (p < 0.05) and in the CE condition (p < 0.01), and on sway along the sagittal plane for the test with CE (p < 0.01). Conclusion: Based on our preliminary findings, we suggest that walking regularly in an outdoor setting could lead to a greater body balance in older people and could be recommended by geriatricians for preventing the risk of falls. The next step will be to investigate the effect of an experimental outdoor walking program structured in terms of intensity, frequency and volume.

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SATISFACTION AND EXPERIENCE WITH THE UNITY SUSPENSION SYSTEM

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v1i2.32030 ◽

2018 ◽

Author(s):

Hossein Gholizadeh ◽

Edward D Lemaire ◽

David Nielen ◽

Patrick Lebel

Keyword(s):

Range Of Motion ◽

Oral Presentation ◽

User Satisfaction ◽

Suspension System ◽

The Other ◽

Scientific Committee ◽

National Assembly ◽

Suspension Systems

BACKGROUND While elevated vacuum suspension systems have some benefits over the other suspension approaches 1–5, elevated vacuum may not be appropriate for all amputees. The Unity sleeveless vacuum suspension system was developed to overcome issues related to knee range of motion and amputees comfort 6. This study compared the Unity suspension system with suction and pin/lock systems based on user satisfaction and experience with these systems. Abstract PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32030/24447 How to cite: Gholizadeh H, Lemaire E.D, Nielen D, Lebel P. SATISFACTION AND EXPERIENCE WITH THE UNITY SUSPENSION SYSTEM. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018.DOI: https://doi.org/10.33137/cpoj.v1i2.32030 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee. http://www.aopanet.org/

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Characterization of Multiple Movement Strategies in Participants With Chronic Ankle Instability

Journal of Athletic Training ◽

10.4085/1062-6050-480-17 ◽

2019 ◽

Vol 54 (6) ◽

pp. 698-707 ◽

Cited By ~ 1

Author(s):

J. Ty Hopkins ◽

S. Jun Son ◽

Hyunsoo Kim ◽

Garritt Page ◽

Matthew K. Seeley

Keyword(s):

Sagittal Plane ◽

Ankle Instability ◽

Vertical Jump ◽

Frontal Plane ◽

Chronic Ankle Instability ◽

Control Group ◽

Ground Reaction Forces ◽

Sensorimotor Deficits ◽

Movement Strategies ◽

Reaction Forces

Context Chronic ankle instability (CAI) is characterized by multiple sensorimotor deficits, affecting strength, postural control, motion, and movement. Identifying specific deficits is the key to developing appropriate interventions for this patient population; however, multiple movement strategies within this population may limit the ability to identify specific movement deficits. Objective To identify specific movement strategies in a large sample of participants with CAI and to characterize each strategy relative to a sample of uninjured control participants. Design Descriptive laboratory study. Setting Biomechanics laboratory. Patients or Other Participants A total of 200 individuals with CAI (104 men, 96 women; age = 22.3 ± 2.2 years, height = 174.2 ± 9.5 cm, mass = 72.0 ± 14.0 kg) were selected according to the inclusion criteria established by the International Ankle Consortium and were fit into clusters based on movement strategy. A total of 100 healthy individuals serving as controls (54 men, 46 women; age = 22.2 ± 3.0 years, height = 173.2 ± 9.2 cm, mass = 70.7 ± 13.4 kg) were compared with each cluster. Main Outcome Measure(s) Lower extremity joint biomechanics and ground reaction forces were collected during a maximal vertical jump landing, followed immediately by a side cut. Data were reduced to functional output or curves, kinematic data from the frontal and sagittal planes were reduced to a single representative curve for each plane, and representative curves were clustered using a Bayesian clustering technique. Estimated functions for each dependent variable were compared with estimated functions from the control group to describe each cluster. Results Six distinct clusters were identified from the frontal-plane and sagittal-plane data. Differences in joint angles, joint moments, and ground reaction forces between clusters and the control group were also identified. Conclusions The participants with CAI demonstrated 6 distinct movement strategies, indicating that CAI could be characterized by multiple distinct movement alterations. Clinicians should carefully evaluate patients with CAI for sensorimotor deficits and quality of movement to determine the appropriate interventions for treatment.

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Energy Expenditure of Transfemoral Amputees Walking on a Horizontal and Tilted Treadmill Simulating Different Outdoor Walking Conditions

Prosthetics and Orthotics International ◽

10.3109/03093640903585016 ◽

2010 ◽

Vol 34 (2) ◽

pp. 184-194 ◽

Cited By ~ 17

Author(s):

Inger-Marie Starholm ◽

Terje Gjovaag ◽

Anne Marit Mengshoel

Keyword(s):

Energy Expenditure ◽

Oxygen Uptake ◽

Sagittal Plane ◽

Frontal Plane ◽

Gait Pattern ◽

Tilted Surface ◽

Outdoor Walking ◽

Energy Consuming ◽

Transfemoral Amputees ◽

The Difference

Transfemoral amputees often report that walking on tilted pavements or on terrain with the prosthesis on the side of higher elevation is quite strenuous. This study investigates the energy expenditure of transfemoral amputees ( n = 8) on a motorized treadmill, simulating different strenuous outdoor walking conditions. Oxygen uptake at self-selected speed of gait was measured during walking at three different treadmill positions: (i) Horizontal treadmill, (ii) 3% tilt in the sagittal plane and (iii) 3% tilt in both the sagittal and frontal plane of the treadmill. The difference in median values of oxygen uptake between position (i) and (ii) was 4.3%, and 16.4% between position (ii) and (iii) ( p ≤ 0.05, for both comparisons). The subjects utilized about 50% of their VO2max when walking in position (i) and (ii), with an increase to about 60% of their VO2max when walking in position (iii). Transfemoral amputees use significantly more energy when walking on a moderately tilted surface in the frontal plane compared to walking with a tilt in the sagittal plane. This is probably because the prosthetic leg becomes functionally too long when the walking surface is tilted sideways, and the transfemoral amputees adopt a more energy consuming gait pattern.

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EVALUATION OF LOCALIZED PAIN IN THE TRANSTIBIAL RESIDUAL LIMB

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v1i2.32028 ◽

2018 ◽

Author(s):

Kamiar Ghoseiri ◽

Mohammad Yusuf Rastkhadiv ◽

Mostafa Allami

Keyword(s):

Quality Of Life ◽

Oral Presentation ◽

Pain Threshold ◽

Scientific Committee ◽

Residual Limb ◽

Skin Damage ◽

National Assembly ◽

Patient Discomfort ◽

Main Component

PURPOSE The socket is the main component of a prosthesis which surrounds the residual limb and transfers loads and motions between the residual limb and prosthesis. A misfit socket may lead to excessive stresses on the residual limb, pistoning of the prosthesis during walking, patient discomfort, pain, and skin damage. The quality of socket-skin interface directly affects quality of life, prosthesis use, and satisfaction from prosthesis in amputees. Pain is a devastating condition that prohibits prosthesis use1-4. The present study aimed to evaluate pain threshold and tolerance of the transtibial residual limb to improve its socket design and fit. Abstract PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32028/24445 How to cite: Ghoseiri K, Rastkhadiv M.Y, Allami M. EVALUATION OF LOCALIZED PAIN IN THE TRANSTIBIAL RESIDUAL LIMB. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32028 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee. http://www.aopanet.org/

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Sit-to-Stand in People with Stroke: Effect of Lower Limb Constraint-Induced Movement Strategies

Stroke Research and Treatment ◽

10.1155/2014/683681 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Charla Krystine Gray ◽

Elsie Culham

Keyword(s):

Sagittal Plane ◽

Weight Bearing ◽

Frontal Plane ◽

Centre Of Mass ◽

Centre Of Pressure ◽

Convenience Sample ◽

Sit To Stand ◽

Movement Strategies ◽

Mass Displacement ◽

Foot Position

Background. Weight-bearing asymmetry and impaired balance may contribute to the increased fall risk in people with stroke when rising to stand from sitting.Objective. This study investigated the effect of constraint-induced movement (CIM) strategies on weight-bearing symmetry and balance during sit-to-stand in people with stroke.Methods. A nonrandom convenience sample of fifteen people with stroke performed the sit-to-stand task using three CIM strategies including a solid or compliant (foam) block strategy, with the unaffected limb placed on the block, and an asymmetrical foot position strategy, with the unaffected limb placed ahead of the affected limb. Duration of the task, affected limb weight-bearing, and centre of pressure and centre of mass displacement were measured in the frontal and sagittal plane.Results. Affected limb weight-bearing was increased and frontal plane centre of pressure and centre of mass moved toward the affected limb compared to baseline with all CIM strategies. Centre of mass displacement in the sagittal plane was greater with the compliant block and asymmetrical foot strategies.Conclusions. The CIM strategies demonstrated greater loading of the affected limb and movement of the centre of pressure and centre of mass toward the affected limb. The compliant block and asymmetrical foot conditions may challenge sagittal plane balance during sit-to-stand in people with stroke.

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A PROSPECTIVE STUDY OF CRANIAL ORTHOTIC TREATMENT OF INFANTS WITH ISOLATED DEFORMATIONAL BRACHYCEPHALY

Canadian Prosthetics & Orthotics Journal ◽

10.33137/cpoj.v1i2.32024 ◽

2018 ◽

Author(s):

Kevin M Kelly ◽

Edward Joganic ◽

Stephen P Beals ◽

Jeff A Riggs ◽

Mary Kay McGuire ◽

...

Keyword(s):

Prospective Study ◽

Oral Presentation ◽

Scientific Committee ◽

Treatment Results ◽

National Assembly ◽

A Prospective Study ◽

Efficacy Of Treatment ◽

Orthotic Treatment ◽

Entrance Age

OBJECTIVES The study objectives were to prospectively evaluate treatment results of infants presenting with isolated deformational brachycephaly following use of a cranial orthosis, and to investigate the role of entrance age on efficacy of treatment. Abstract PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32024/24441 How to cite: Kelly K.M, Joganic E, Beals S.P, Riggs J.A, McGuire M.K, Littlefield T.R. A PROSPECTIVE STUDY OF CRANIAL ORTHOTIC TREATMENT OF INFANTS WITH ISOLATED DEFORMATIONAL BRACHYCEPHALY. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32024 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee. http://www.aopanet.org/

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Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211019346 ◽

2021 ◽

pp. 154596832110193

Author(s):

Sungwoo Park ◽

Chang Liu ◽

Natalia Sánchez ◽

Julie K. Tilson ◽

Sara J. Mulroy ◽

...

Keyword(s):

Angular Momentum ◽

Sagittal Plane ◽

Dynamic Balance ◽

Objective Measure ◽

Frontal Plane ◽

Step Length ◽

Berg Balance Scale ◽

Whole Body ◽

Functional Gait ◽

Full Body

Background People poststroke often walk with a spatiotemporally asymmetric gait, due in part to sensorimotor impairments in the paretic lower extremity. Although reducing asymmetry is a common objective of rehabilitation, the effects of improving symmetry on balance are yet to be determined. Objective We established the concurrent validity of whole-body angular momentum as a measure of balance, and we determined if reducing step length asymmetry would improve balance by decreasing whole-body angular momentum. Methods We performed clinical balance assessments and measured whole-body angular momentum during walking using a full-body marker set in a sample of 36 people with chronic stroke. We then used a biofeedback-based approach to modify step length asymmetry in a subset of 15 of these individuals who had marked asymmetry and we measured the resulting changes in whole-body angular momentum. Results When participants walked without biofeedback, whole-body angular momentum in the sagittal and frontal plane was negatively correlated with scores on the Berg Balance Scale and Functional Gait Assessment supporting the validity of whole-body angular momentum as an objective measure of dynamic balance. We also observed that when participants walked more symmetrically, their whole-body angular momentum in the sagittal plane increased rather than decreased. Conclusions Voluntary reductions of step length asymmetry in people poststroke resulted in reduced measures of dynamic balance. This is consistent with the idea that after stroke, individuals might have an implicit preference not to deviate from their natural asymmetry while walking because it could compromise their balance. Clinical Trials Number: NCT03916562.

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DOES BRAIN ACTIVATION DURING FUNCTIONAL MOVEMENT TASKS DIFFERENTIATE BETWEEN GOOD AND BAD MOVERS? AN INTEGRATED NEUROIMAGING ASSESSMENT OF MOTOR CONTROL IN YOUNG ATHLETES

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00134 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0013

Author(s):

Manish Anand ◽

Jed A. Diekfuss ◽

Dustin R. Grooms ◽

Alexis B. Slutsky-Ganesh ◽

Scott Bonnette ◽

...

Keyword(s):

Motor Control ◽

Range Of Motion ◽

Brain Function ◽

Sagittal Plane ◽

Brain Activity ◽

Frontal Plane ◽

Acl Injury ◽

Timing Error ◽

Lingual Gyrus ◽

Increased Activity

Background: Aberrant frontal and sagittal plane knee motor control biomechanics contribute to increased anterior cruciate ligament (ACL) injury risk. Emergent data further indicates alterations in brain function may underlie ACL injury high risk biomechanics and primary injury. However, technical limitations have limited our ability to assess direct linkages between maladaptive biomechanics and brain function. Hypothesis/Purpose: (1) Increased frontal plane knee range of motion would associate with altered brain activity in regions important for sensorimotor control and (2) increased sagittal plane knee motor control timing error would associate with altered activity in sensorimotor control brain regions. Methods: Eighteen female high-school basketball and volleyball players (14.7 ± 1.4 years, 169.5 ± 7 cm, 65.8 ± 20.5 kg) underwent brain functional magnetic resonance imaging (fMRI) while performing a bilateral, combined hip, knee, and ankle flexion/extension movements against resistance (i.e., leg press) Figure 1(a). The participants completed this task to a reference beat of 1.2 Hz during four movement blocks of 30 seconds each interleaved in between 5 rest blocks of 30 seconds each. Concurrent frontal and sagittal plane range of motion (ROM) kinematics were measured using an MRI-compatible single camera motion capture system. Results: Increased frontal plane ROM was associated with increased brain activity in one cluster extending over the occipital fusiform gyrus and lingual gyrus ( p = .003, z > 3.1). Increased sagittal plane motor control timing error was associated with increased brain activity in multiple clusters extending over the occipital cortex (lingual gyrus), frontal cortex, and anterior cingulate cortex ( p < .001, z > 3.1); see Figure 1 (b). Conclusion: The associations of increased knee frontal plane ROM and sagittal plane timing error with increased activity in regions that integrate visuospatial information may be indicative of an increased propensity for knee injury biomechanics that are, in part, driven by reduced spatial awareness and an inability to adequately control knee abduction motion. Increased activation in these regions during movement tasks may underlie an impaired ability to control movements (i.e., less neural efficiency), leading to compromised knee positions during more complex sports scenarios. Increased activity in regions important for cognition/attention associating with motor control timing error further indicates a neurologically inefficient motor control strategy. [Figure: see text]

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Biologically Inspired Design and Development of a Variable Stiffness Powered Ankle-Foot Prosthesis

Journal of Mechanisms and Robotics ◽

10.1115/1.4043603 ◽

2019 ◽

Vol 11 (4) ◽

Cited By ~ 1

Author(s):

Alexander Agboola-Dobson ◽

Guowu Wei ◽

Lei Ren

Keyword(s):

Lower Limb ◽

Degrees Of Freedom ◽

Sagittal Plane ◽

Frontal Plane ◽

Variable Stiffness ◽

Plane Motion ◽

Biologically Inspired ◽

Passive Rotation ◽

Ground Conditions ◽

Biologically Inspired Design

Recent advancements in powered lower limb prostheses have appeased several difficulties faced by lower limb amputees by using a series-elastic actuator (SEA) to provide powered sagittal plane flexion. Unfortunately, these devices are currently unable to provide both powered sagittal plane flexion and two degrees of freedom (2-DOF) at the ankle, removing the ankle’s capacity to invert/evert, thus severely limiting terrain adaption capabilities and user comfort. The developed 2-DOF ankle system in this paper allows both powered flexion in the sagittal plane and passive rotation in the frontal plane; an SEA emulates the biomechanics of the gastrocnemius and Achilles tendon for flexion while a novel universal-joint system provides the 2-DOF. Several studies were undertaken to thoroughly characterize the capabilities of the device. Under both level- and sloped-ground conditions, ankle torque and kinematic data were obtained by using force-plates and a motion capture system. The device was found to be fully capable of providing powered sagittal plane motion and torque very close to that of a biological ankle while simultaneously being able to adapt to sloped terrain by undergoing frontal plane motion, thus providing 2-DOF at the ankle. These findings demonstrate that the device presented in this paper poses radical improvements to powered prosthetic ankle-foot device (PAFD) design.

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