Potential and Limitations of Feedback-Supported Gait Retraining in Users of Lower Limb Prostheses

Kaitlyn Marie Rayl; Goeran Fiedler

doi:10.3390/prosthesis3020018

Potential and Limitations of Feedback-Supported Gait Retraining in Users of Lower Limb Prostheses

Prosthesis ◽

10.3390/prosthesis3020018 ◽

2021 ◽

Vol 3 (2) ◽

pp. 181-189

Author(s):

Kaitlyn Marie Rayl ◽

Goeran Fiedler

Keyword(s):

Lower Limb ◽

Patient Characteristics ◽

Target Population ◽

Long Term Effects ◽

Gait Retraining ◽

Rehabilitation Programs ◽

Published Evidence ◽

Gait Parameters ◽

Feedback Modalities ◽

Lower Limb Prostheses

The outcomes of prosthetic rehabilitation after lower limb loss are, in large part, affected by the effectiveness of the provided gait retraining. The noted prevalence of adverse long-term effects, such as further joint and muscle degeneration, suggests that traditional rehabilitation programs have limitations. Recent advances in technology and in the understanding of motor learning promise the potential for better gait retraining interventions. This article reviews current literature on systems and methodologies of improving gait parameters in those with lower limb prostheses via exercise programs and various biofeedback systems. A total of 13 articles were included in the qualitative analysis. Findings indicate that many of the investigated systems are able to effectively analyze and change gait in the target population, but there remain considerable gaps in the knowledge. It has been noted that feedback modalities and dosage must be customized based on patient characteristics and rehabilitation goals, yet there is currently not enough published evidence to inform such customization.

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Effect of observation on lower limb prosthesis gait biomechanics: Preliminary results

Prosthetics and Orthotics International ◽

10.1177/0309364615605374 ◽

2016 ◽

Vol 40 (6) ◽

pp. 739-743 ◽

Cited By ~ 4

Author(s):

Connor Malchow ◽

Goeran Fiedler

Keyword(s):

Outcome Measures ◽

Lower Limb ◽

Gait Pattern ◽

Upper Body ◽

Secondary Outcome ◽

Double Support ◽

Lateral Tilt ◽

Gait Parameters ◽

Lower Limb Prosthesis ◽

Lower Limb Prostheses

Background: The Hawthorne effect, a subcategory of reactivity, causes human behavior to change when under observation. Such an effect may apply to gait variation of persons with prosthetics or orthotics devices. Objectives: This study investigated whether the presence of observers directly affects the gait pattern of users of lower limb prostheses. Study design: Within-subject intervention study. Methods: Primary outcome measures were gait parameters of initial double support time and upper body lateral tilt angle, which were collected with a mobile sensor attached to the subjects’ back. To make subjects feel unwatched, a certain amount of deception was necessary, and two different conditions were created and statistically compared against each other: one in which the subjects were initially unaware of the attention of observers and another one in which the same subjects were aware of a group of observers. Results: Data from two subjects using trans-femoral prosthesis are reported. Findings included a change in step initial double support percentage by up to 14.2% ( p = 0.019). Considerable changes were also noted in secondary outcome measures including speed, stride length, and stride symmetry. Conclusions: A reactivity effect of observation exists in prosthetics gait analysis. More comprehensive studies may be motivated by these preliminary findings. Clinical relevance Results of this study suggest that users of lower limb prostheses walk differently when their gait is being assessed (e.g. in the prosthetist’s office) than in situations without observers. This may in part explain the clinical experience that modifications of prosthetic fit or alignment provide only short-term betterment.

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Deficits in Selective Attention Alter Gait in Frail Older Adults

GeroPsych ◽

10.1024/1662-9647/a000137 ◽

2016 ◽

Vol 29 (1) ◽

pp. 29-36 ◽

Cited By ~ 2

Author(s):

Véronique Cornu ◽

Jean-Paul Steinmetz ◽

Carine Federspiel

Keyword(s):

Older Adults ◽

Nursing Home ◽

Selective Attention ◽

Dual Task ◽

Nursing Home Residents ◽

Gait Rehabilitation ◽

Rehabilitation Programs ◽

Gait Parameters ◽

Growing Body ◽

Task Conditions

Abstract. A growing body of research demonstrates an association between gait disorders, falls, and attentional capacities in older adults. The present work empirically analyzes differences in gait parameters in frail institutionalized older adults as a function of selective attention. Gait analysis under single- and dual-task conditions as well as selective attention measures were collected from a total of 33 nursing-home residents. We found that differences in selective attention performances were related to the investigated gait parameters. Poorer selective attention performances were associated with higher stride-to-stride variabilities and a slowing of gait speed under dual-task conditions. The present findings suggest a contribution of selective attention to a safe gait. Implications for gait rehabilitation programs are discussed.

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Adherence and Perspiration While Wearing Lower Limb Prostheses

Case Medical Research ◽

10.31525/ct1-nct03900845 ◽

2019 ◽

Author(s):

Keyword(s):

Lower Limb ◽

Lower Limb Prostheses

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Prosthetics. Structural testing of lower-limb prostheses

10.3403/01030497 ◽

1997 ◽

Keyword(s):

Lower Limb ◽

Structural Testing ◽

Lower Limb Prostheses

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Prosthetics. Structural testing of lower-limb prostheses

10.3403/01030461u ◽

2015 ◽

Keyword(s):

Lower Limb ◽

Structural Testing ◽

Lower Limb Prostheses

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Prosthetics. Structural testing of lower-limb prostheses. Requirements and test methods

10.3403/30334015 ◽

2016 ◽

Keyword(s):

Lower Limb ◽

Test Methods ◽

Structural Testing ◽

Lower Limb Prostheses

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Adaptive Foot in Lower-Limb Prostheses

Journal of Robotics ◽

10.1155/2017/9618375 ◽

2017 ◽

Vol 2017 ◽

pp. 1-15 ◽

Cited By ~ 2

Author(s):

Thilina H. Weerakkody ◽

Thilina Dulantha Lalitharatne ◽

R. A. R. C. Gopura

Keyword(s):

Lower Limb ◽

Uneven Surface ◽

Design Concepts ◽

Human Foot ◽

Future Developments ◽

Adaptive Capabilities ◽

Adaptive Nature ◽

Lower Limb Amputees ◽

Artificial Prosthesis ◽

Lower Limb Prostheses

The human foot consists of complex sets of joints. The adaptive nature of the human foot enables it to be stable on any uneven surface. It is important to have such adaptive capabilities in the artificial prosthesis to achieve most of the essential movements for lower-limb amputees. However, many existing lower-limb prostheses lack the adaptive nature. This paper reviews lower-limb adaptive foot prostheses. In order to understand the design concepts of adaptive foot prostheses, the biomechanics of human foot have been explained. Additionally, the requirements and design challenges are investigated and presented. In this review, adaptive foot prostheses are classified according to actuation method. Furthermore, merits and demerits of present-day adaptive foot prostheses are presented based on the hardware construction. The hardware configurations of recent adaptive foot prostheses are analyzed and compared. At the end, potential future developments are highlighted.

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