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Hip joint and muscle loading for persons with bilateral transfemoral/through-knee amputations: biomechanical differences between full-length articulated and foreshortened non-articulated prostheses.
Toderita, Diana; Favier, Clement D; Henson, David P; Vardakastani, Vasiliki; Sherman, Kate; Bennett, Alexander N; Bull, Anthony M J.
Afiliación
  • Toderita D; Department of Bioengineering, Imperial College London, London, UK. diana.toderita15@imperial.ac.uk.
  • Favier CD; Department of Bioengineering, Imperial College London, London, UK.
  • Henson DP; Department of Bioengineering, Imperial College London, London, UK.
  • Vardakastani V; Department of Bioengineering, Imperial College London, London, UK.
  • Sherman K; Dorset Orthopaedic GB, Manchester, UK.
  • Bennett AN; Defence Medical Rehabilitation Centre, Loughborough, UK.
  • Bull AMJ; Department of Bioengineering, Imperial College London, London, UK.
J Neuroeng Rehabil ; 20(1): 169, 2023 12 19.
Article en En | MEDLINE | ID: mdl-38115144
ABSTRACT

BACKGROUND:

Currently, there is little available in-depth analysis of the biomechanical effect of different prostheses on the musculoskeletal system function and residual limb internal loading for persons with bilateral transfemoral/through-knee amputations (BTF). Commercially available prostheses for BTF include full-length articulated prostheses (microprocessor-controlled prosthetic knees with dynamic response prosthetic feet) and foreshortened non-articulated stubby prostheses. This study aims to assess and compare the BTF musculoskeletal function and loading during gait with these two types of prostheses.

METHODS:

Gait data were collected from four male traumatic military BTF and four able-bodied (AB) matched controls using a 10-camera motion capture system with two force plates. BTF completed level-ground walking trials with full-length articulated and foreshortened non-articulated stubby prostheses. Inverse kinematics, inverse dynamics and musculoskeletal modelling simulations were conducted.

RESULTS:

Full-length articulated prostheses introduced larger stride length (by 0.5 m) and walking speed (by 0.3 m/s) than stubbies. BTF with articulated prostheses showed larger peak hip extension angles (by 10.1°), flexion moment (by 1.0 Nm/kg) and second peak hip contact force (by 3.8 bodyweight) than stubbies. There was no difference in the hip joint loading profile between BTF with stubbies and AB for one gait cycle. Full-length articulated prostheses introduced higher hip flexor muscle force impulse than stubbies.

CONCLUSIONS:

Compared to stubbies, BTF with full-length articulated prostheses can achieve similar activity levels to persons without limb loss, but this may introduce detrimental muscle and hip joint loading, which may lead to reduced muscular endurance and joint degeneration. This study provides beneficial guidance in making informed decisions for prosthesis choice.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Miembros Artificiales / Amputados Límite: Humans / Male Idioma: En Revista: J Neuroeng Rehabil Asunto de la revista: ENGENHARIA BIOMEDICA / NEUROLOGIA / REABILITACAO Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Miembros Artificiales / Amputados Límite: Humans / Male Idioma: En Revista: J Neuroeng Rehabil Asunto de la revista: ENGENHARIA BIOMEDICA / NEUROLOGIA / REABILITACAO Año: 2023 Tipo del documento: Article Pais de publicación: Reino Unido