Does use of a powered ankle-foot prosthesis restore whole-body angular momentum during walking at different speeds?
Clin Orthop Relat Res
; 472(10): 3044-54, 2014 Oct.
Article
em En
| MEDLINE
| ID: mdl-24781926
ABSTRACT
BACKGROUND:
Whole-body angular momentum (H) influences fall risk, is tightly regulated during walking, and is primarily controlled by muscle force generation. People with transtibial amputations using passive-elastic prostheses typically have greater H compared with nonamputees. QUESTIONS/PURPOSES:
(1) Do people with unilateral transtibial amputations using passive-elastic prostheses have greater sagittal and frontal plane H ranges of motion during walking compared with nonamputees and compared with using powered prostheses? (2) Does use of powered ankle-foot prostheses result in equivalent H ranges in all planes of motion compared with nonamputees during walking as a result of normative prosthetic ankle power generation?METHODS:
Eight patients with a unilateral transtibial amputation and eight nonamputees walked 0.75, 1.00, 1.25, 1.50, and 1.75 m/s while we measured kinematics and ground reaction forces. We calculated H for participants using their passive-elastic prosthesis and a powered ankle-foot prosthesis and for nonamputees at each speed.RESULTS:
Patients using passive-elastic prostheses had 32% to 59% greater sagittal H ranges during the affected leg stance phase compared with nonamputees at 1.00 to 1.75 m/s (p < 0.05). Patients using passive-elastic prostheses had 5% and 9% greater sagittal H ranges compared with using powered prostheses at 1.25 and 1.50 m/s, respectively (p < 0.05). Participants using passive-elastic prostheses had 29% and 17% greater frontal H ranges at 0.75 and 1.50 m/s, respectively, compared with nonamputees (p < 0.05). Surprisingly, patients using powered prostheses had 26% to 50% greater sagittal H ranges during the affected leg stance phase compared with nonamputees at 1.00 to 1.75 m/s (p < 0.05). Patients using powered prostheses also had 26% greater frontal H range compared with nonamputees at 0.75 m/s (p < 0.05).CONCLUSIONS:
People with a transtibial amputation may more effectively regulate H at two specific walking speeds when using powered compared with passive-elastic prostheses. CLINICAL RELEVANCE Our results support the hypothesis that an ankle-foot prosthesis capable of providing net positive work during the stance phase of walking reduces sagittal plane H; future studies are needed to validate our biomechanical findings with larger numbers of patients and should determine whether powered prostheses can decrease the risk of falls in patients with a transtibial amputation.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desenho de Prótese
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Membros Artificiais
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Tíbia
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Caminhada
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Marcha
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Amputação Cirúrgica
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Amputados
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Traumatismos da Perna
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Articulação do Tornozelo
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article