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Kobayashi T, Jor A, He Y, Hu M, Koh MWP, Hisano G, Hara T, Hobara H. Transfemoral prosthetic simulators versus amputees: ground reaction forces and spatio-temporal parameters in gait. ROYAL SOCIETY OPEN SCIENCE 2024; 11:231854. [PMID: 38545618 PMCID: PMC10966393 DOI: 10.1098/rsos.231854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 04/26/2024]
Abstract
This study aimed to compare the ground reaction forces (GRFs) and spatio-temporal parameters as well as their asymmetry ratios in gait between individuals wearing a transfemoral prosthetic simulator (TFSim) and individuals with unilateral transfemoral amputation (TFAmp) across a range of walking speeds (2.0-5.5 km h-1). The study recruited 10 non-disabled individuals using TFSim and 10 individuals with unilateral TFAmp using a transfemoral prosthesis. Data were collected using an instrumented treadmill with built-in force plates, and subsequently, the GRFs and spatio-temporal parameters, as well as their asymmetry ratios, were analysed. When comparing the TFSim and TFAmp groups, no significant differences were found among the gait parameters and asymmetry ratios of all tested metrics except the vertical GRFs. The TFSim may not realistically reproduce the vertical GRFs during the weight acceptance and push-off phases. The structural and functional variations in prosthetic limbs and components between the TFSim and TFAmp groups may be primary contributors to the difference in the vertical GRFs. These results suggest that TFSim might be able to emulate the gait of individuals with TFAmp regarding the majority of spatio-temporal and GRF parameters. However, the vertical GRFs of TFSim should be interpreted with caution.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Abu Jor
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
- Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Yufan He
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Mingyu Hu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Mark W. P. Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Genki Hisano
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
- Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Takeshi Hara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
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Luo S, Shu X, Zhu H, Yu H. Design and optimization of a new integrated hip and knee prosthesis structure. Artif Organs 2024; 48:50-60. [PMID: 37877242 DOI: 10.1111/aor.14667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/23/2023] [Accepted: 10/05/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Conventional hip disarticulation prostheses (HDPs) are passive devices with separate joint structures, limiting amputees' ability to control and resulting in abnormal gait patterns. This study introduces a new HDP integrating the hip and knee joints for amputees' natural gait. METHODS The new HDP restores the physiological rotation center of the hip with a remote center of motion (RCM) structure, and simulates the knee motion with a four-bar structure. Nonlinear programming was employed to optimize the hip-knee joint structure. A hybrid multi-objective drive structure with a series-parallel connection was also designed to ensure motion synergy between the hip and knee joints. Finally, a prototype of the prosthesis was tested using the HDP test system. RESULTS The optimization results demonstrate that the new HDP accurately restores the rotation center of the femur in amputees, with the knee's instantaneous center of rotation (ICR) trajectory closely resembling that of the human knee (Pearson correlation coefficient is 0.999). The study shows that the new HDP achieves a motion reproduction accuracy of over 95% for the human hip joint at walking speeds above 1.5 km/h, 38% higher than conventional prosthesis. Similarly, at the same walking speed, the new HDP replicates the motion of the human knee at 82.89%, surpassing conventional prosthesis by 57.85%. CONCLUSIONS The new HDP restores symmetry and replicates synergistic movement in amputees' lower limbs, exhibiting superior movement characteristics compared to conventional prostheses. This innovative HDP has the potential to enhance the quality of life for amputees.
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Affiliation(s)
- Shengli Luo
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Xiaolong Shu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Hexiang Zhu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
| | - Hongliu Yu
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai, China
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Hu M, He Y, Hisano G, Hobara H, Kobayashi T. Coordination of Lower Limb During Gait in Individuals With Unilateral Transfemoral Amputation. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3835-3843. [PMID: 37721878 DOI: 10.1109/tnsre.2023.3316749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Understanding the lower-limb coordination of individuals with unilateral transfemoral amputation (uTFA) while walking is essential to understand their gait mechanisms. Continuous relative phase (CRP) analysis provides insights into gait coordination patterns of the neuromusculoskeletal system based on movement kinematics. Fourteen individuals with uTFA and their age-matched non-disabled individuals participated in this study. Kinematic data of the lower limbs of the participants were collected during walking. The joint angles, segment angles, and CRP values of the thigh-shank and shank-foot couplings were investigated. The curves among the lower limbs of the participants were compared using a statistical parametric mapping test. Compensatory strategies were found in the lower limbs from coordination patterns. In thigh-shank coupling, although distinct coordination traits in stance and swing phases among the lower limbs were found, the lower limbs in both groups were discovered to remain in a similar coordination pattern during gait. For individuals with uTFA, in shank-foot coupling, intact limbs demonstrated a short period of foot-leading pattern which was significantly different from that of the other limbs during mid-stance to compensate for the weaker force generation by prosthetic limbs. The findings offer normative coordination patterns on the walking of individuals with uTFA, which could benefit prosthetic gait rehabilitation and development.
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Pace A, Proksch L, Grioli G, Aszmann OC, Bicchi A, Catalano MG. An Experimental Setup to Test Obstacle-Dealing Capabilities of Prosthetic Feet. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941253 DOI: 10.1109/icorr58425.2023.10304763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Small obstacles on the ground often lead to a fall when caught with commercial prosthetic feet. Despite some recently developed feet can actively control the ankle angle, for instance over slopes, their flat and rigid sole remains a cause of instability on uneven grounds. Soft robotic feet were recently proposed to tackle that issue; however, they lack consistent experimental validation. Therefore, this paper describes the experimental setup realized to test soft and rigid prosthetic feet with lower-limb prosthetic users. It includes a wooden walkway and differently shaped obstacles. It was preliminary validated with an able-bodied subject, the same subject walking on commercial prostheses through modified walking boots, and with a prosthetic user. They performed walking firstly on even ground, and secondly on even ground stepping on one of the obstacles. Results in terms of vertical ground reaction force and knee moments in both the sagittal and frontal planes show how the poor performance of commonly used prostheses is exacerbated in case of obstacles. The prosthetic user, indeed, noticeably relies on the sound leg to compensate for the stiff and unstable interaction of the prosthetic limb with the obstacle. Therefore, since the limitations of non-adaptive prosthetic feet in obstacle-dealing emerge from the experiments, as expected, this study justifies the use of the setup for investigating the performance of soft feet on uneven grounds and obstacle negotiation.
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Kobayashi T, Koh MWP, Jor A, Hisano G, Murata H, Ichimura D, Hobara H. Ground reaction forces during double limb stances while walking in individuals with unilateral transfemoral amputation. Front Bioeng Biotechnol 2023; 10:1041060. [PMID: 36727041 PMCID: PMC9885323 DOI: 10.3389/fbioe.2022.1041060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
The asymmetrical gait of individuals with unilateral transfemoral amputation has been well documented. However, there is not a wealth of investigation into asymmetries during the double limb stance depending on whether the intact or prosthetic limb is leading. The first aim of this study was to compare ground reaction forces during the double limb stance of individuals with unilateral transfemoral amputation depending on whether their intact (initial double limb stance) or prosthetic (terminal double limb stance) limb was leading. The second aim of this study was to compare the asymmetry ratio of ground reaction forces during the double limb stance between individuals with and without unilateral transfemoral amputation. Thirty individuals, fifteen with unilateral transfemoral amputation and fifteen who were able-bodied, were recruited for this study. Each individual walked on an instrumented treadmill for 30 s at eight different speeds, ranging from 2.0 km/h to 5.5 km/h with .5 km/h increments. Ground reaction force parameters, temporal parameters, and asymmetry ratios of all parameters were computed from the data collected. The appropriate statistical analyses of all data based on normality were conducted to investigate the aims of this study. Significant main effects of speed, double limb stance, and their interactions were found for most parameters (p < .01 or p < .05). Individuals with unilateral transfemoral amputation spent a longer duration in terminal double limb stance than initial double limb stance at all tested speeds. They also experienced significantly higher peak vertical ground reaction force during initial double limb stance compared to terminal double limb stance with increasing walking speed. However, during terminal double limb stance, higher anteroposterior ground reaction force at initial contact was found when compared to initial double limb stance. Significant differences between individuals with unilateral transfemoral amputation and able-bodied individuals were found in asymmetry ratios for peak vertical ground reaction force, anteroposterior ground reaction force, anteroposterior shear, and mediolateral shear at all tested speeds. Asymmetrical loading persists in individuals with unilateral transfemoral amputation during double limb stance. Increasing walking speed increased ground reaction force loading asymmetries, which may make individuals with unilateral transfemoral amputation more susceptible to knee osteoarthritis or other musculoskeletal disorders. Further study is necessary to develop ideal gait strategies for the minimization of gait asymmetry in individuals with unilateral transfemoral amputation.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mark W. P. Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Abu Jor
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China,Department of Leather Engineering, Faculty of Mechanical Engineering, Khulna University of Engineering & Technology, Khulna, Bangladesh
| | - Genki Hisano
- Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan,Research Fellow of Japan Society for the Promotion of Science (JSPS), Tokyo, Japan,Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Hiroto Murata
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan,*Correspondence: Hiroaki Hobara,
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Ichimura D, Hobara H, Hisano G, Maruyama T, Tada M. Acquisition of bipedal locomotion in a neuromusculoskeletal model with unilateral transtibial amputation. Front Bioeng Biotechnol 2023; 11:1130353. [PMID: 36937747 PMCID: PMC10014613 DOI: 10.3389/fbioe.2023.1130353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/20/2023] [Indexed: 03/05/2023] Open
Abstract
Adaptive locomotion is an essential behavior for animals to survive. The central pattern generator in the spinal cord is responsible for the basic rhythm of locomotion through sensory feedback coordination, resulting in energy-efficient locomotor patterns. Individuals with symmetrical body proportions exhibit an energy-efficient symmetrical gait on flat ground. In contrast, individuals with lower limb amputation, who have morphologically asymmetrical body proportions, exhibit asymmetrical gait patterns. However, it remains unclear how the nervous system adjusts the control of the lower limbs. Thus, in this study, we investigated how individuals with unilateral transtibial amputation control their left and right lower limbs during locomotion using a two-dimensional neuromusculoskeletal model. The model included a musculoskeletal model with 7 segments and 18 muscles, as well as a neural model with a central pattern generator and sensory feedback systems. Specifically, we examined whether individuals with unilateral transtibial amputation acquire prosthetic gait through a symmetric or asymmetric feedback control for the left and right lower limbs. After acquiring locomotion, the metabolic costs of transport and the symmetry of the spatiotemporal gait factors were evaluated. Regarding the metabolic costs of transportation, the symmetric control model showed values approximately twice those of the asymmetric control model, whereas both scenarios showed asymmetry of spatiotemporal gait patterns. Our results suggest that individuals with unilateral transtibial amputation can reacquire locomotion by modifying sensory feedback parameters. In particular, the model reacquired reasonable locomotion for activities of daily living by re-searching asymmetric feedback parameters for each lower limb. These results could provide insight into effective gait assessment and rehabilitation methods to reacquire locomotion in individuals with unilateral transtibial amputation.
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Affiliation(s)
- Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
- *Correspondence: Daisuke Ichimura,
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
| | - Genki Hisano
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
- Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan
- Research Fellow of Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Tsubasa Maruyama
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Mitsunori Tada
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
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Liu T, Liu X, Li Y, Wang A, Chen S, Wu S, Hou S, Fan H, Cao C. Associations of Traumatic Injury with Abnormal Glucose Metabolism: A Population-Based Prospective Cohort Study. Clin Epidemiol 2023; 15:325-336. [PMID: 36936063 PMCID: PMC10022519 DOI: 10.2147/clep.s399920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/22/2023] [Indexed: 03/14/2023] Open
Abstract
Purpose Empirical data on the association between traumatic injury and abnormal glucose metabolism risk is limited. This study aimed to investigate the association between traumatic injury and abnormal glucose metabolism. Patients and Methods This study included 153,162 participants in the Kailuan Study from 2006 to 2013. Participants with abnormal glucose metabolism at baseline were excluded. All participants were monitored every two years until December 31, 2019. During follow-up, 1915 subjects with a first traumatic injury (defined as a physical injury caused by an external force) were identified. For each subject with traumatic injury, one control subject was randomly selected and matched for age (± 3 years) and sex. A total of 3830 subjects were included in the final analysis. Cox proportional hazards models were used to examine the association between traumatic injury and the subsequent risk of abnormal glucose metabolism. Results During a median follow-up of 6.91 (3.57-9.41) years, 990 abnormal glucose metabolism events occurred. After adjustment for demographics, lifestyle behaviors, and traditional risk factors, those who had traumatic injury compared to controls were 32% more likely to develop any abnormal glucose metabolism (hazard ratio [HR] 1.32; 95% confidence interval [CI]1.16-1.49), including impaired fasting glucose (IFG) (HR 1.29; 95% CI 1.12-1.48) and diabetes (HR 1.37; 95% CI 1.10-1.70). The risks for abnormal glucose metabolism, IFG, and diabetes in subjects with moderate-severe injury were higher than in subjects with mild injury for the 1-year follow-up period, while the association was not significantly different by injury severity for the whole follow-up period. Conclusion Traumatic injury was associated with an increased risk of abnormal glucose metabolism. However, the risks of outcome events decreased as the follow-up period extended. Improved short- and long-term prevention and management strategies for controlling glucose are needed for individuals with traumatic injury.
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Affiliation(s)
- Tao Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
| | - Xin Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
| | - Yue Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
| | - Aitian Wang
- Department of Intensive Medicine, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, People’s Republic of China
| | - Shike Hou
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
| | - Haojun Fan
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
| | - Chunxia Cao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, People’s Republic of China
- Correspondence: Chunxia Cao; Haojun Fan, Institute of Disaster and Emergency Medicine, Tianjin University, No. 92 Weijin Road, Nankai District, Tianjin, 300072, People’s Republic of China, Tel +86 02227893596, Fax +86 02227893596-307, Email ;
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8
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Ichimura D, Amma R, Hisano G, Murata H, Hobara H. Spatiotemporal gait patterns in individuals with unilateral transfemoral amputation: A hierarchical cluster analysis. PLoS One 2022; 17:e0279593. [PMID: 36548294 PMCID: PMC9778493 DOI: 10.1371/journal.pone.0279593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
Gait pattern classification in individuals with lower-limb amputation could help in developing personalized prosthetic prescriptions and tailored gait rehabilitation. However, systematic classifications of gait patterns in this population have been scarcely explored. This study aimed to determine whether the gait patterns in individuals with unilateral transfemoral amputation (UTFA) can be clustered into homogeneous subgroups using spatiotemporal parameters across a range of walking speeds. We examined spatiotemporal gait parameters, including step length and cadence, in 25 individuals with UTFA (functional level K3 or K4, all non-vascular amputations) while they walked on a split-belt instrumented treadmill at eight speeds. Hierarchical cluster analysis (HCA) was used to identify clusters with homogeneous gait patterns based on the relationships between step length and cadence. Furthermore, after cluster formation, post-hoc analyses were performed to compare the spatiotemporal parameters and demographic data among the clusters. HCA identified three homogeneous gait pattern clusters, suggesting that individuals with UTFA have several gait patterns. Further, we found significant differences in the participants' body height, sex ratio, and their prosthetic knee component among the clusters. Therefore, gait rehabilitation should be individualized based on body size and prosthetic prescription.
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Affiliation(s)
- Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
- * E-mail:
| | - Ryo Amma
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Genki Hisano
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
- Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan
- Research Fellow of the Japan Society for the Promotion of Science (JSPS), Japan
| | - Hiroto Murata
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Hiroaki Hobara
- Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
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9
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Shen KH, Prajapati SK, Borrelli J, Gray VL, Westlake KP, Rogers MW, Hsiao HY. Neuromechanical control of impact absorption during induced lower limb loading in individuals post-stroke. Sci Rep 2022; 12:19104. [PMID: 36352032 PMCID: PMC9646771 DOI: 10.1038/s41598-022-21271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/26/2022] [Indexed: 11/11/2022] Open
Abstract
Decreased loading of the paretic lower limb and impaired weight transfer between limbs negatively impact balance control and forward progression during gait in individuals post-stroke. However, the biomechanical and neuromuscular control mechanisms underlying such impaired limb loading remain unclear, partly due to their tendency of avoiding bearing weight on the paretic limb during voluntary movement. Thus, an approach that forces individuals to more fully and rapidly load the paretic limb has been developed. The primary purpose of this study was to compare the neuromechanical responses at the ankle and knee during externally induced limb loading in people with chronic stroke versus able-bodied controls, and determine whether energy absorption capacity, measured during induced limb loading of the paretic limb, was associated with walking characteristics in individuals post-stroke. Results revealed reduced rate of energy absorption and dorsiflexion velocity at the ankle joint during induced limb loading in both the paretic and non-paretic side in individuals post-stroke compared to healthy controls. The co-contraction index was higher in the paretic ankle and knee joints compared to the non-paretic side. In addition, the rate of energy absorption at the paretic ankle joint during the induced limb loading was positively correlated with maximum walking speed and negatively correlated with double limb support duration. These findings demonstrated that deficits in ankle dorsiflexion velocity may limit the mechanical energy absorption capacity of the joint and thereby affect the lower limb loading process during gait following stroke.
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Affiliation(s)
- Keng-Hung Shen
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
| | - Sunil K Prajapati
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA
- Department of Applied Physiology and Wellness, Southern Methodist University, Dallas, TX, USA
| | - James Borrelli
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
- Department of Biomedical Engineering, Stevenson University, Baltimore, MD, USA
| | - Vicki L Gray
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Kelly P Westlake
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Mark W Rogers
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA
| | - Hao-Yuan Hsiao
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, USA.
- Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA.
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10
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Ichimura D, Hisano G, Murata H, Kobayashi T, Hobara H. Centre of pressure during walking after unilateral transfemoral amputation. Sci Rep 2022; 12:17501. [PMID: 36261465 PMCID: PMC9582189 DOI: 10.1038/s41598-022-22254-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/12/2022] [Indexed: 01/12/2023] Open
Abstract
Lower-limb amputation imposes a health burden on amputees; thus, gait assessments are required prophylactically and clinically, particularly for individuals with unilateral transfemoral amputation (UTFA). The centre of pressure (COP) during walking is one of the most useful parameters for evaluating gait. Although superimposed COP trajectories reflect the gait characteristics of individuals with neurological disorders, the quantitative characteristics based on the COP trajectories of individuals with UTFA remain unclear. Thus, these COP trajectories were investigated across a range of walking speeds in this study. The COP trajectories were recorded on a split-belt force-instrumented treadmill at eight walking speeds. Asymmetry and variability parameters were compared based on the COP trajectories of 25 individuals with UTFA and 25 able-bodied controls. The COP trajectories of the individuals with UTFA were significantly larger in lateral asymmetry and variability but did not show significant differences in anterior-posterior variability compared with those of the able-bodied controls. Further, the individuals with UTFA demonstrated larger lateral asymmetry at lower speeds. These results suggest that (1) individuals with UTFA adopt orientation-specific balance control strategies during gait and (2) individuals with UTFA could also be exposed to a higher risk of falling at lower walk speeds.
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Affiliation(s)
- Daisuke Ichimura
- grid.208504.b0000 0001 2230 7538Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan
| | - Genki Hisano
- grid.208504.b0000 0001 2230 7538Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan ,grid.32197.3e0000 0001 2179 2105Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan ,grid.54432.340000 0001 0860 6072Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Hiroto Murata
- grid.208504.b0000 0001 2230 7538Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan ,grid.143643.70000 0001 0660 6861Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Toshiki Kobayashi
- grid.16890.360000 0004 1764 6123Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hiroaki Hobara
- grid.208504.b0000 0001 2230 7538Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan ,grid.143643.70000 0001 0660 6861Faculty of Advanced Engineering, Tokyo University of Science, Tokyo, Japan
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Alhossary A, Ang WT, Chua KSG, Tay MRJ, Ong PL, Murakami T, Quake T, Binedell T, Wee SK, Phua MW, Wei YJ, Donnelly CJ. Identification of Secondary Biomechanical Abnormalities in the Lower Limb Joints after Chronic Transtibial Amputation: A Proof-of-Concept Study Using SPM1D Analysis. Bioengineering (Basel) 2022; 9:bioengineering9070293. [PMID: 35877344 PMCID: PMC9311753 DOI: 10.3390/bioengineering9070293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/24/2022] Open
Abstract
SPM is a statistical method of analysis of time-varying human movement gait signal, depending on the random field theory (RFT). MovementRx is our inhouse-developed decision-support system that depends on SPM1D Python implementation of the SPM (spm1d.org). We present the potential application of MovementRx in the prediction of increased joint forces with the possibility to predispose to osteoarthritis in a sample of post-surgical Transtibial Amputation (TTA) patients who were ambulant in the community. We captured the three-dimensional movement profile of 12 males with TTA and studied them using MovementRx, employing the SPM1D Python library to quantify the deviation(s) they have from our corresponding reference data, using “Hotelling 2” and “T test 2” statistics for the 3D movement vectors of the 3 main lower limb joints (hip, knee, and ankle) and their nine respective components (3 joints × 3 dimensions), respectively. MovementRx results visually demonstrated a clear distinction in the biomechanical recordings between TTA patients and a reference set of normal people (ABILITY data project), and variability within the TTA patients’ group enabled identification of those with an increased risk of developing osteoarthritis in the future. We conclude that MovementRx is a potential tool to detect increased specific joint forces with the ability to identify TTA survivors who may be at risk for osteoarthritis.
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Affiliation(s)
- Amr Alhossary
- Rehabilitation Research Institute of Singapore-Nanyang Technological University, Singapore 308232, Singapore; (A.A.); (W.T.A.); (Y.J.W.)
| | - Wei Tech Ang
- Rehabilitation Research Institute of Singapore-Nanyang Technological University, Singapore 308232, Singapore; (A.A.); (W.T.A.); (Y.J.W.)
| | - Karen Sui Geok Chua
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Matthew Rong Jie Tay
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Poo Lee Ong
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Tsurayuki Murakami
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Tabitha Quake
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Trevor Binedell
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Seng Kwee Wee
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Min Wee Phua
- Centre of Rehabilitation Excellence, Tan Tock Seng Hospital, Singapore 569766, Singapore; (K.S.G.C.); (M.R.J.T.); (P.L.O.); (T.M.); (T.Q.); (T.B.); (S.K.W.); (M.W.P.)
| | - Yong Jia Wei
- Rehabilitation Research Institute of Singapore-Nanyang Technological University, Singapore 308232, Singapore; (A.A.); (W.T.A.); (Y.J.W.)
| | - Cyril John Donnelly
- Rehabilitation Research Institute of Singapore-Nanyang Technological University, Singapore 308232, Singapore; (A.A.); (W.T.A.); (Y.J.W.)
- Correspondence: ; Tel.: +65-6904-1363
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Kobayashi T, Koh MWP, Hu M, Murata H, Hisano G, Ichimura D, Hobara H. Effects of step frequency during running on the magnitude and symmetry of ground reaction forces in individuals with a transfemoral amputation. J Neuroeng Rehabil 2022; 19:33. [PMID: 35321725 PMCID: PMC8944140 DOI: 10.1186/s12984-022-01012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individuals with unilateral transfemoral amputation are prone to developing health conditions such as knee osteoarthritis, caused by additional loading on the intact limb. Such individuals who can run again may be at higher risk due to higher ground reaction forces (GRFs) as well as asymmetric gait patterns. The two aims of this study were to investigate manipulating step frequency as a method to reduce GRFs and its effect on asymmetric gait patterns in individuals with unilateral transfemoral amputation while running. METHODS This is a cross-sectional study. Nine experienced track and field athletes with unilateral transfemoral amputation were recruited for this study. After calculation of each participant's preferred step frequency, each individual ran on an instrumented treadmill for 20 s at nine different metronome frequencies ranging from - 20% to + 20% of the preferred frequency in increments of 5% with the help of a metronome. From the data collected, spatiotemporal parameters, three components of peak GRFs, and the components of GRF impulses were computed. The asymmetry ratio of all parameters was also calculated. Statistical analyses of all data were conducted with appropriate tools based on normality analysis to investigate the main effects of step frequency. For parameters with significant main effects, linear regression analyses were further conducted for each limb. RESULTS Significant main effects of step frequency were found in multiple parameters (P < 0.01). Both peak GRF and GRF impulse parameters that demonstrated significant main effects tended towards decreasing magnitude with increasing step frequency. Peak vertical GRF in particular demonstrated the most symmetric values between the limbs from - 5% to 0% metronome frequency. All parameters that demonstrated significant effects in asymmetry ratio became more asymmetric with increasing step frequency. CONCLUSIONS For runners with a unilateral transfemoral amputation, increasing step frequency is a viable method to decrease the magnitude of GRFs. However, with the increase of step frequency, further asymmetry in gait is observed. The relationships between step frequency, GRFs, and the asymmetry ratio in gait may provide insight into the training of runners with unilateral transfemoral amputation for the prevention of injury.
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Affiliation(s)
- Toshiki Kobayashi
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mark W P Koh
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mingyu Hu
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hiroto Murata
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.,Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Genki Hisano
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.,Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan.,Research Fellow of Japan Society for the Promotion of Science (JSPS), Tokyo, Japan
| | - Daisuke Ichimura
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan
| | - Hiroaki Hobara
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Waterfront 3F, 2-3-26, Aomi, Koto-ku, Tokyo, 135-0064, Japan.
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Effects of Walking Speed and Prosthetic Knee Control Type on External Mechanical Work in Transfemoral Prosthesis Users. J Biomech 2022; 134:110984. [DOI: 10.1016/j.jbiomech.2022.110984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/10/2022] [Accepted: 01/28/2022] [Indexed: 11/19/2022]
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