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Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device
BACKGROUND: There are many studies that have investigated biomechanical differences among prosthetic feet, but not changes due to adaptation over time. There is a need for objective measures to quantify the process of adaptation for individuals with a transtibial amputation. Mechanical power and wor...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787280/ https://www.ncbi.nlm.nih.gov/pubmed/29374491 http://dx.doi.org/10.1186/s12984-018-0347-1 |
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author | Ray, Samuel F. Wurdeman, Shane R. Takahashi, Kota Z. |
author_facet | Ray, Samuel F. Wurdeman, Shane R. Takahashi, Kota Z. |
author_sort | Ray, Samuel F. |
collection | PubMed |
description | BACKGROUND: There are many studies that have investigated biomechanical differences among prosthetic feet, but not changes due to adaptation over time. There is a need for objective measures to quantify the process of adaptation for individuals with a transtibial amputation. Mechanical power and work profiles are a primary focus for modern energy-storage-and-return type prostheses, which strive to increase energy return from the prosthesis. The amount of energy a prosthesis stores and returns (i.e., negative and positive work) during stance is directly influenced by the user’s loading strategy, which may be sensitive to alterations during the course of an adaptation period. The purpose of this study was to examine changes in lower limb mechanical work profiles during walking following a three-week adaptation to a new prosthesis. METHODS: A retrospective analysis was performed on 22 individuals with a unilateral transtibial amputation. Individuals were given a new prosthesis at their current mobility level (K3 or above) and wore it for three weeks. Kinematic and kinetic measures were recorded from overground walking at 0, 1.5, and 3 weeks into the adaptation period at a self-selected pace. Positive and negative work done by the prosthesis and sound ankle-foot were calculated using a unified deformable segment model and a six-degrees-of-freedom model for the knee and hip. RESULTS: Positive work from the prosthesis ankle-foot increased by 6.1% and sound ankle-foot by 5.7% after 3 weeks (p = 0.041, 0.036). No significant changes were seen in negative work from prosthesis or sound ankle-foot (p = 0.115, 0.192). There was also a 4.1% increase in self-selected walking speed after 3 weeks (p = 0.038). Our data exhibited large inter-subject variations, in which some individuals followed group trends in work profiles while others had opposite trends in outcome variables. CONCLUSIONS: After a 3-week adaptation, 14 out of 22 individuals with a transtibial amputation increased energy return from the prosthesis. Such findings could indicate that individuals may better utilize the spring-like function of the prosthesis after an adaptation period. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12984-018-0347-1) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5787280 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-57872802018-02-08 Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device Ray, Samuel F. Wurdeman, Shane R. Takahashi, Kota Z. J Neuroeng Rehabil Research BACKGROUND: There are many studies that have investigated biomechanical differences among prosthetic feet, but not changes due to adaptation over time. There is a need for objective measures to quantify the process of adaptation for individuals with a transtibial amputation. Mechanical power and work profiles are a primary focus for modern energy-storage-and-return type prostheses, which strive to increase energy return from the prosthesis. The amount of energy a prosthesis stores and returns (i.e., negative and positive work) during stance is directly influenced by the user’s loading strategy, which may be sensitive to alterations during the course of an adaptation period. The purpose of this study was to examine changes in lower limb mechanical work profiles during walking following a three-week adaptation to a new prosthesis. METHODS: A retrospective analysis was performed on 22 individuals with a unilateral transtibial amputation. Individuals were given a new prosthesis at their current mobility level (K3 or above) and wore it for three weeks. Kinematic and kinetic measures were recorded from overground walking at 0, 1.5, and 3 weeks into the adaptation period at a self-selected pace. Positive and negative work done by the prosthesis and sound ankle-foot were calculated using a unified deformable segment model and a six-degrees-of-freedom model for the knee and hip. RESULTS: Positive work from the prosthesis ankle-foot increased by 6.1% and sound ankle-foot by 5.7% after 3 weeks (p = 0.041, 0.036). No significant changes were seen in negative work from prosthesis or sound ankle-foot (p = 0.115, 0.192). There was also a 4.1% increase in self-selected walking speed after 3 weeks (p = 0.038). Our data exhibited large inter-subject variations, in which some individuals followed group trends in work profiles while others had opposite trends in outcome variables. CONCLUSIONS: After a 3-week adaptation, 14 out of 22 individuals with a transtibial amputation increased energy return from the prosthesis. Such findings could indicate that individuals may better utilize the spring-like function of the prosthesis after an adaptation period. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12984-018-0347-1) contains supplementary material, which is available to authorized users. BioMed Central 2018-01-27 /pmc/articles/PMC5787280/ /pubmed/29374491 http://dx.doi.org/10.1186/s12984-018-0347-1 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Ray, Samuel F. Wurdeman, Shane R. Takahashi, Kota Z. Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title | Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title_full | Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title_fullStr | Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title_full_unstemmed | Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title_short | Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
title_sort | prosthetic energy return during walking increases after 3 weeks of adaptation to a new device |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5787280/ https://www.ncbi.nlm.nih.gov/pubmed/29374491 http://dx.doi.org/10.1186/s12984-018-0347-1 |
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