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Amputee biomechanics

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https://www.readbyqxmd.com/read/29132264/leg-amputation-side-determines-performance-in-curve-sprinting-a-case-study-on-a-paralympic-medalist
#1
Johannes Funken, Kai Heinrich, Steffen Willwacher, Ralf Müller, Jonas Böcker, Hiroaki Hobara, Gert-Peter Brüggemann, Wolfgang Potthast
The lower limb kinetics of curve sprinting in amputees are not well described in the literature, particularly with respect to the effect of the side of amputation. This is an issue due to the importance of the knowledge for prosthetic design and classification of athletes. Thus, the aim of this study was to investigate the influence of side of amputation on curve sprinting performance in athletes with a unilateral leg amputation. A three-dimensional motion analysis system (Vicon), four force plates (Kistler) and a modified mathematical human model (ALASKA) were used to compare clockwise and counter clockwise curve sprinting lower limb kinematics and kinetics of a Paralympic medalist with a left-sided knee exarticular amputation...
November 13, 2017: Sports Biomechanics
https://www.readbyqxmd.com/read/29051334/case-studies-in-physiology-the-biomechanics-of-the-fastest-sprinter-with-a-unilateral-transtibial-amputation
#2
Owen N Beck, Alena Marie Grabowski
People have debated whether athletes with transtibial amputations should compete with non-amputees in track events despite insufficient information regarding how the use of running-specific prostheses affects athletic performance. Thus, we sought to quantify the spatio-temporal variables, ground reaction forces, and spring-mass mechanics of the fastest athlete with a unilateral transtibial amputation using an RSP to reveal how he adapts his biomechanics to achieve elite running speeds. Accordingly, we measured ground reaction forces during treadmill running trials spanning 2...
October 19, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28952363/identification-of-the-critical-level-of-implantation-of-an-osseointegrated-prosthesis-for-above-knee-amputees
#3
Elder Michael Andrango Castro, Svatava Konvickova, Matej Daniel, Zdenek Horak
The aim of our study was to identify potential critical levels of implantation of an osseointegrated prosthesis for above-knee amputees. The implant used was the OPRA system. It was inserted in the femur at four different amputation heights, characterized by their residual limb ratios (0.299, 0.44, 0.58 and 0.73). The stress and strain distribution was evaluated in the bone-implant system during walking, considering a body mass of 100 kg. Considerably high stimulus (11,489 με) in the tissue near the tip was found at the highest implantation level...
September 27, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28946826/when-to-biomechanically-examine-a-lower-limb-amputee-a-systematic-review-of-accommodation-times
#4
Andrea B Wanamaker, Rebecca R Andridge, Ajit Mw Chaudhari
BACKGROUND: Hundreds of investigations examining biomechanical outcomes of various prostheses have been completed, but one question remains unanswered: how much time should an amputee be given to accommodate to a new prosthesis prior to biomechanical testing? OBJECTIVE: To examine the literature for accommodation time given during biomechanical investigations to determine whether consensus exists. STUDY DESIGN: Systematic review. METHODS: A systematic search was completed on 7 January 2016 using PubMed and Scopus...
October 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28927643/a-combined-kinematic-and-kinetic-analysis-at-the-residuum-socket-interface-of-a-knee-disarticulation-amputee
#5
Jinghua Tang, Michael McGrath, Nick Hale, Liudi Jiang, Dan Bader, Piotr Laszczak, David Moser, Saeed Zahedi
The bespoke interface between a lower limb residuum and a prosthetic socket is critical for an amputee's comfort and overall rehabilitation outcomes. Analysis of interface kinematics and kinetics is important to gain full understanding of the interface biomechanics, which could aid clinical socket fit, rehabilitation and amputee care. This pilot study aims to investigate the dynamic correlation between kinematic movement and kinetic stresses at the interface during walking tests on different terrains. One male, knee disarticulation amputee participated in the study...
November 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28885156/the-vspa-foot-a-quasi-passive-ankle-foot-prosthesis-with-continuously-variable-stiffness
#6
Max K Shepherd, Elliott J Rouse
Most commercially available prosthetic feet do not exhibit a biomimetic torque-angle relationship, and are unable to modulate their mechanics to assist with other mobility tasks, such as stairs and ramps. In this work, we present a quasi-passive ankle-foot prosthesis with a customizable torque-angle curve and an ability to quickly modulate ankle stiffness between tasks. The customizable torque-angle curve is obtained with a cam-based transmission and a fiberglass leaf spring. To achieve variable stiffness, the leaf spring's support conditions can be actively modulated by a small motor, shifting the torque-angle curve to be more or less stiff...
September 7, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28813971/feasibility-study-of-transtibial-amputee-walking-using-a-powered-prosthetic-foot
#7
Martin Grimmer, Matthew Holgate, Jeffrey Ward, Alexander Boehler, Andre Seyfarth
Passive prosthetic feet are not able to provide non-amputee kinematics and kinetics for the ankle joint. Persons with amputations show reduced interlimb symmetry, slower walking speeds, and increased walking effort. To improve ankle range of motion and push off, various powered prosthetic feet were introduced. This feasibility study analyzed if predefined motor reference trajectories can be used to achieve non-amputee ankle biomechanics during walking with the powered prosthetic foot, Walk-Run Ankle. Trajectories were calculated using the desired ankle angle and ankle moment based spring deflection at a given spring stiffness...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28763712/crossover-study-of-amputee-stair-ascent-and-descent-biomechanics-using-genium-and-c-leg-prostheses-with-comparison-to-non-amputee-control
#8
Derek J Lura, Matthew W Wernke, Stephanie L Carey, Jason T Kahle, Rebecca M Miro, M Jason Highsmith
This study was a randomized crossover of stair ambulation of Transfemoral Amputees (TFAs) using the Genium and C-Leg prosthetic knees. TFAs typically have difficulty ascending and descending stairs, limiting community mobility. The objective of this study was to determine the relative efficacy of the Genium and C-Leg prostheses for stair ascent and descent, and their absolute efficacy relative to non-amputees. Twenty TFAs, and five non-amputees participated in the study. TFAs were randomized to begin the study with the Genium or C-Leg prosthesis...
October 2017: Gait & Posture
https://www.readbyqxmd.com/read/28499159/sensitivity-of-biomechanical-outcomes-to-independent-variations-of-hindfoot-and-forefoot-stiffness-in-foot-prostheses
#9
Peter Gabriel Adamczyk, Michelle Roland, Michael E Hahn
Many studies have reported the effects of different foot prostheses on gait, but most results cannot be generalized because the prostheses' properties are seldom reported. We varied hindfoot and forefoot stiffness in an experimental foot prosthesis, in increments of 15N/mm, and tested the parametric effects of these variations on treadmill walking in unilateral transtibial amputees, at speeds from 0.7 to 1.5m/s. We computed outcomes such as prosthesis energy return, center of mass (COM) mechanics, ground reaction forces, and joint mechanics, and computed their sensitivity to component stiffness...
August 2017: Human Movement Science
https://www.readbyqxmd.com/read/28487630/analysis-of-interrelationships-among-voluntary-and-prosthetic-leg-joint-parameters-using-cyclograms
#10
Farahiyah Jasni, Nur Azah Hamzaid, Nor Elleeiana Mohd Syah, Tze Y Chung, Noor Azuan Abu Osman
The walking mechanism of a prosthetic leg user is a tightly coordinated movement of several joints and limb segments. The interaction among the voluntary and mechanical joints and segments requires particular biomechanical insight. This study aims to analyze the inter-relationship between amputees' voluntary and mechanical coupled leg joints variables using cyclograms. From this analysis, the critical gait parameters in each gait phase were determined and analyzed if they contribute to a better powered prosthetic knee control design...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28470462/-connecting-adapter-for-coupling-exoprostheses-to-endoshafts-demands-on-orthopedic-technicians-with-respect-to-planning-and-application
#11
H Grundei, A Timmermann
INTRODUCTION: Transcutaneous, bone anchored prostheses have proved to be an alternative for amputees. In addition to the safe osseointegration of the implant, the correct prosthetic alignment is also important. Therefore, the interaction between prosthesis components and the prosthesis wearer is significant and the role of the certified prosthetist should not be underestimated. AIM: The aim of treatment is the best possible compensation of disability after limb loss with increase of physical abilities and comfort of the prosthesis wearer by means of bone anchored prosthesis...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28399722/safety-and-function-of-a-prototype-microprocessor-controlled-knee-prosthesis-for-low-active-transfemoral-amputees-switching-from-a-mechanic-knee-prosthesis-a-pilot-study
#12
Timothy Hasenoehrl, Thomas Schmalz, Reinhard Windhager, Stephan Domayer, Sara Dana, Clemens Ambrozy, Stefano Palma, Richard Crevenna
PURPOSE: Aim of this pilot study was to assess safety and functioning of a microprocessor-controlled knee prosthesis (MPK) after a short familiarization time and no structured physical therapy. MATERIALS AND METHODS: Five elderly, low-active transfemoral amputees who were fitted with a standard non-microprocessor controlled knee prosthesis (NMPK) performed a baseline measurement consisting of a 3 D gait analysis, functional tests and questionnaires. The first follow-up consisted of the same test procedure and was performed with the MPK after 4 to 6 weeks of familiarization...
April 11, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#13
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
May 2017: Gait & Posture
https://www.readbyqxmd.com/read/28280845/-function-of-prosthesis-components-in-lower-limb-amputees-with-bone-anchored-percutaneous-implants-biomechanical-aspects
#14
S Blumentritt
BACKGROUND: Bone anchorage of an artificial limb has been proven to be an alternative intervention for amputees when prosthesis use is seriously reduced because of stump problems. Little is known about how prosthesis components interact with bone and joints and which potential the optimum use provides with respect to quality of treatment of leg amputees. OBJECTIVE: Does osseointegration influence the motor activity of residual limbs differently compared with socket prostheses? How should prosthesis components be aligned? What type of prosthetic knee joints should be preferred in transfemoral amputees? MATERIAL AND METHODS: Transfer of biomechanical knowledge of socket prosthetics to bone-anchored prostheses...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28273496/ertl-and-non-ertl-amputees-exhibit-functional-biomechanical-differences-during-the-sit-to-stand-task
#15
Abbie E Ferris, Cory L Christiansen, Gary D Heise, David Hahn, Jeremy D Smith
BACKGROUND: People with transtibial amputation stand ~50times/day. There are two general approaches to transtibial amputation: 1) distal tibia and fibula union using a "bone-bridge" (Ertl), 2) non-union of the tibia and fibula (Non-Ertl). The Ertl technique may improve functional outcomes by increasing the end-bearing ability of the residual limb. We hypothesized individuals with an Ertl would perform a five-time sit-to-stand task faster through greater involvement/end-bearing of the affected limb...
May 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28229193/osseointegrated-prostheses-for-rehabilitation-following-amputation-the-pioneering-swedish-model
#16
REVIEW
Yan Li, Rickard Brånemark
The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program...
April 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28126335/two-biomechanical-strategies-for-locomotor-adaptation-to-split-belt-treadmill-walking-in-subjects-with-and-without-transtibial-amputation
#17
Brian P Selgrade, Megan E Toney, Young-Hui Chang
Locomotor adaptation is commonly studied using split-belt treadmill walking, in which each foot is placed on a belt moving at a different speed. As subjects adapt to split-belt walking, they reduce metabolic power, but the biomechanical mechanism behind this improved efficiency is unknown. Analyzing mechanical work performed by the legs and joints during split-belt adaptation could reveal this mechanism. Because ankle work in the step-to-step transition is more efficient than hip work, we hypothesized that control subjects would reduce hip work on the fast belt and increase ankle work during the step-to-step transition as they adapted...
February 28, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28113346/control-and-evaluation-of-a-powered-transfemoral-prosthesis-for-stair-ascent
#18
Elissa D Ledoux, Michael Goldfarb
This paper assesses the metabolic effort exerted by three transfemoral amputees, when using a powered knee and ankle prosthesis for stair ascent, relative to ascending stairs with passive knee and ankle prostheses. The paper describes a controller that provides step-over stair ascent behavior reflective of healthy stair ascent biomechanics, and describes its implementation in a powered prosthesis prototype. Stair ascent experiments were performed with three unilateral transfemoral amputee subjects, comparing the oxygen consumption required to ascend stairs using the powered prosthesis (with a step-over gait), relative to using their daily-use energetically passive prostheses (with a step-to gait)...
July 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28095358/axial-and-torsional-stiffness-of-pediatric-prosthetic-feet
#19
Paolo Taboga, Alena M Grabowski
BACKGROUND: Prosthetic stiffness likely affects the walking biomechanics of toddlers and children with leg amputations, but the actual stiffness values for prostheses are not reported by manufacturers or in standardized testing procedures. AIM: We measured axial (kA) and torsional (kT) stiffness from four brands of pediatric prosthetic feet (Trulife, Kingsley Mfg. Co., TRS Incorporated, and College Park Industries) over a range of foot sizes. METHODS: We applied forces and torques onto prostheses with a materials testing machine that replicated those exhibited in vivo by using the kinetics measured from four non-amputee toddlers (2-3years) during walking...
February 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28066520/gait-training-interventions-for-lower-extremity-amputees-a-systematic-literature-review
#20
M Jason Highsmith, Casey R Andrews, Claire Millman, Ashley Fuller, Jason T Kahle, Tyler D Klenow, Katherine L Lewis, Rachel C Bradley, John J Orriola
Lower extremity (LE) amputation patients who use prostheses have gait asymmetries and altered limb loading and movement strategies when ambulating. Subsequent secondary conditions are believed to be associated with gait deviations and lead to long-term complications that impact function and quality of life as a result. The purpose of this study was to systematically review the literature to determine the strength of evidence supporting gait training interventions and to formulate evidence statements to guide practice and research related to therapeutic gait training for lower extremity amputees...
September 2016: Technology and Innovation
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