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Amputee biomechanics

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https://www.readbyqxmd.com/read/28499159/sensitivity-of-biomechanical-outcomes-to-independent-variations-of-hindfoot-and-forefoot-stiffness-in-foot-prostheses
#1
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...
May 9, 2017: Human Movement Science
https://www.readbyqxmd.com/read/28487630/analysis-of-interrelationships-among-voluntary-and-prosthetic-leg-joint-parameters-using-cyclograms
#2
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
#3
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
#4
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
#5
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...
February 21, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28280845/-function-of-prosthesis-components-in-lower-limb-amputees-with-bone-anchored-percutaneous-implants-biomechanical-aspects
#6
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
#7
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
#8
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
#9
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
#10
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)...
January 20, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28095358/axial-and-torsional-stiffness-of-pediatric-prosthetic-feet
#11
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...
January 5, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28066520/gait-training-interventions-for-lower-extremity-amputees-a-systematic-literature-review
#12
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
https://www.readbyqxmd.com/read/27918675/biomechanics-in-paralympics-implications-for-performance
#13
Floor Morriën, Matthew J D Taylor, Florentina J Hettinga
PURPOSE: To provide an overview of biomechanical studies in Paralympic research and their relevance for performance in Paralympic sports. METHODS: Search terms ' Paralympic Biomechanics', 'Paralympic Sport Performance', 'Paralympic Athlete Performance', and Paralympic Athlete' were entered into the electronic database PubMed. RESULTS: Thirty-four studies were included. Biomechanical studies in Paralympics mainly contributed to performance enhancement by technical optimization (n=32) and/or injury prevention (n=6)...
December 5, 2016: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/27614614/characteristics-and-adaptive-strategies-linked-with-falls-in-stroke-survivors-from-analysis-of-laboratory-induced-falls
#14
Claire F Honeycutt, Masood Nevisipour, Mark D Grabiner
Falls are the most common and expensive medical complication in stroke survivors. There is remarkably little information about what factors lead to a fall in stroke survivors. With few exceptions, the falls literature in stroke has focused on relating metrics of static balance and impairment to fall outcomes in the acute care setting or in community. While informative, these studies provide little information about what specific impairments in a stroke-survivor's response to dynamic balance challenges lead to a fall...
October 3, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27497755/reliability-of-3d-gait-data-across-multiple-laboratories
#15
Kenton Kaufman, Emily Miller, Trevor Kingsbury, Elizabeth Russell Esposito, Erik Wolf, Jason Wilken, Marilynn Wyatt
The aim of this study was to analyze the repeatability of gait analysis studies performed across multiple trials, sessions, and laboratories. Ten healthy participants (6 male/4 female, mean age of 30, mean BMI of 24kg/m(2)) were assessed in 3 sessions conducted at each of the three Centers of Excellence for Amputee Care within the Department of Defense. For each test session, kinematic and kinetic parameters were collected during five walking trials for each limb. One independent examiner at each site placed markers on the subjects...
September 2016: Gait & Posture
https://www.readbyqxmd.com/read/27200342/design-and-preliminary-evaluation-of-a-two-dofs-cable-driven-ankle-foot-prosthesis-with-active-dorsiflexion-plantarflexion-and-inversion-eversion
#16
Evandro Maicon Ficanha, Guilherme Aramizo Ribeiro, Houman Dallali, Mohammad Rastgaar
This paper describes the design of an ankle-foot robotic prosthesis controllable in the sagittal and frontal planes. The prosthesis was designed to meet the mechanical characteristics of the human ankle including power, range of motion, and weight. To transfer the power from the motors and gearboxes to the ankle-foot mechanism, a Bowden cable system was used. The Bowden cable allows for optimal placement of the motors and gearboxes in order to improve gait biomechanics such as the metabolic energy cost and gait asymmetry during locomotion...
2016: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/27146289/characteristics-of-a-volume-adjustable-compression-chamber-for-transradial-prosthetic-interface
#17
Yuanjun Sang, Xiang Li, Yun Luo
In the transradial limb-socket contact interface, the physiological properties and prosthetic operating habits of the residual limb might affect the comfort and functionality of the prosthesis. To enhance the comfort and functionality of the interface, a frame-type socket with four volume-adjustable compression chambers was proposed for the transradial amputation level. The contact pressure of the limb-socket interface was adjusted by the volume changes in the chambers and controlled by a vacuum pump and the corresponding control system...
July 2016: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/27117010/shock-absorption-during-transtibial-amputee-gait-does-longitudinal-prosthetic-stiffness-play-a-role
#18
Erin Boutwell, Rebecca Stine, Steven Gard
BACKGROUND: Reduced-stiffness components are often prescribed in lower-limb prostheses, but their efficacy in augmenting shock absorption has been inconclusive. OBJECTIVES: To perform a systematic variation of longitudinal prosthetic stiffness over a wide range of values and to evaluate its effect on shock absorption during gait. STUDY DESIGN: Repeated-measures crossover experiment. METHODS: Twelve subjects with a unilateral transtibial amputation walked at normal and fast self-selected speeds...
April 26, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27087677/biomechanics-of-the-human-walk-to-run-gait-transition-in-persons-with-unilateral-transtibial-amputation
#19
Tracy N Giest, Young-Hui Chang
Propulsive force production (indicative of intrinsic force-length-velocity characteristics of the plantar flexor muscles) has been shown to be a major determinant of the human walk-to-run transition. The purpose of this work was to determine the gait transition speed of persons with unilateral transtibial amputation donning a passive-elastic prosthesis and assess whether a mechanical limit of their intact side plantar flexor muscles is a major determinant of their walk-to-run transition. We determined each individual׳s gait transition speed (GTS) via an incremental protocol and assessed kinetics and kinematics during walking at speeds 50%, 60%, 70%, 80%, 90%, 100%, 120%, and 130% of that gait transition speed (100%:GTS)...
June 14, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/26985053/maximum-speed-curve-running-biomechanics-of-sprinters-with-and-without-unilateral-leg-amputations
#20
Paolo Taboga, Rodger Kram, Alena M Grabowski
On curves, non-amputees' maximum running speed is slower on smaller radii and thought to be limited by the inside leg's mechanics. Similar speed decreases would be expected for non-amputees in both counterclockwise and clockwise directions because they have symmetric legs. However, sprinters with unilateral leg amputation have asymmetric legs, which may differentially affect curve-running performance and Paralympic competitions. To investigate this and understand the biomechanical basis of curve running, we compared maximum curve-running (radius 17...
March 2016: Journal of Experimental Biology
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