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Shi QQ, Yick KL, Wu J, Huang X, Tse CY, Chan MK. A Scientometric Analysis and Visualization of Prosthetic Foot Research Work: 2000 to 2022. Bioengineering (Basel) 2023; 10:1138. [PMID: 37892868 PMCID: PMC10604169 DOI: 10.3390/bioengineering10101138] [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: 08/21/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to highlight recent research work on topics around prosthetic feet through a scientometric analysis and historical review. The most cited publications from the Clarivate Analytics Web of Science Core Collection database were identified and analyzed from 1 January 2000 to 31 October 2022. Original articles, reviews with full manuscripts, conference proceedings, early access documents, and meeting abstracts were included. A scientometric visualization analysis of the bibliometric information related to the publications, including the countries, institutions, journals, references, and keywords, was conducted. A total of 1827 publications met the search criteria in this study. The related publications grouped by year show an overall trend of increase during the two decades from 2000 to 2022. The United States is ranked first in terms of overall influence in this field (n = 774). The Northwestern University has published the most papers on prosthetic feet (n = 84). Prosthetics and Orthotics International has published the largest number of studies on prosthetic feet (n = 151). During recent years, a number of studies with citation bursts and burst keywords (e.g., diabetes, gait, pain, and sensor) have provided clues on the hotspots of prosthetic feet and prosthetic foot trends. The findings of this study are based on a comprehensive analysis of the literature and highlight the research topics on prosthetic feet that have been primarily explored. The data provide guidance to clinicians and researchers to further studies in this field.
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Affiliation(s)
- Qiu-Qiong Shi
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
| | - Kit-Lun Yick
- Laboratory for Artificial Intelligence in Design, Hong Kong, China;
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing 400715, China;
| | - Xujia Huang
- School of Recreational Sports and Tourism, Beijing Sport University, Beijing 100084, China;
| | - Chi-Yung Tse
- Centre for Orthopaedic Surgery, Hong Kong, China;
| | - Mei-Ki Chan
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong, China;
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Kooiman VGM, van Staveren ES, Leijendekkers RA, Buurke JH, Verdonschot N, Prinsen EC, Weerdesteyn V. Testing and evaluation of lower limb prosthesis prototypes in people with a transfemoral amputation: a scoping review on research protocols. J Neuroeng Rehabil 2023; 20:1. [PMID: 36635703 PMCID: PMC9835280 DOI: 10.1186/s12984-023-01125-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 01/07/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND When developing new lower limb prostheses, prototypes are tested to obtain insights into the performance. However, large variations between research protocols may complicate establishing the potential added value of newly developed prototypes over other prostheses. OBJECTIVE This review aims at identifying participant characteristics, research protocols, reference values, aims, and corresponding outcome measures used during prosthesis prototype testing on people with a transfemoral amputation. METHODS A systematic search was done on PubMed and Scopus from 2000 to December 2020. Articles were included if testing was done on adults with transfemoral or knee disarticulation amputation; testing involved walking with a non-commercially available prototype leg prosthesis consisting of at least a knee component; and included evaluations of the participants' functioning with the prosthesis prototype. RESULTS From the initial search of 2027 articles, 48 articles were included in this review. 20 studies were single-subject studies and 4 studies included a cohort of 10 or more persons with a transfemoral amputation. Only 5 articles reported all the pre-defined participant characteristics that were deemed relevant. The familiarization time with the prosthesis prototype prior to testing ranged from 5 to 10 min to 3 months; in 25% of the articles did not mention the extent of the familiarization period. Mobility was most often mentioned as the development or testing aim. A total of 270 outcome measures were identified, kinetic/kinematic gait parameters were most often reported. The majority of outcome measures corresponded to the mobility aim. For 48% of the stated development aims and 4% of the testing aims, no corresponding outcome measure could be assigned. Results indicated large inconsistencies in research protocols and outcome measures used to validate pre-determined aims. CONCLUSIONS The large variation in prosthesis prototype testing and reporting calls for the development of a core set of reported participant characteristics, testing protocols, and specific and well-founded outcome measures, tailored to the various aims and development phases. The use of such a core set can give greater insights into progress of developments and determine which developments have additional benefits over the state-of-the-art. This review may contribute as initial input towards the development of such a core set.
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Affiliation(s)
- Vera G. M. Kooiman
- grid.10417.330000 0004 0444 9382Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Eline S. van Staveren
- grid.419315.bRoessingh Research and Development, PO Box 310, 7500 AH Enschede, The Netherlands
| | - Ruud A. Leijendekkers
- grid.10417.330000 0004 0444 9382Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.10417.330000 0004 0444 9382Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Jaap H. Buurke
- grid.419315.bRoessingh Research and Development, PO Box 310, 7500 AH Enschede, The Netherlands ,Roessingh Center for Rehabilitation, Postbus 310, 7500 AH Enschede, The Netherlands ,grid.6214.10000 0004 0399 8953Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Nico Verdonschot
- grid.10417.330000 0004 0444 9382Orthopedic Research Laboratory, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.6214.10000 0004 0399 8953Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Erik C. Prinsen
- grid.419315.bRoessingh Research and Development, PO Box 310, 7500 AH Enschede, The Netherlands ,grid.6214.10000 0004 0399 8953Department of Biomechanical Engineering, Faculty of Engineering Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Vivian Weerdesteyn
- grid.10417.330000 0004 0444 9382Department of Rehabilitation, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands ,grid.452818.20000 0004 0444 9307Sint Maartenskliniek, Research & Rehabilitation, P.O. Box 9011, 6500 GM Nijmegen, The Netherlands
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Kuhlmann A, Hagberg K, Kamrad I, Ramstrand N, Seidinger S, Berg H. The Kenevo microprocessor-controlled prosthetic knee compared with non-microprocessor-controlled knees in individuals older than 65 years in Sweden: A cost-effectiveness and budget-impact analysis. Prosthet Orthot Int 2022; 46:414-424. [PMID: 35511441 PMCID: PMC9554759 DOI: 10.1097/pxr.0000000000000138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND Growing evidence suggests that individuals with transfemoral amputation or knee disarticulation using a prosthesis equipped with a microprocessor-controlled knee (MPK) benefit from enhanced mobility and safety, including less falls. In elderly individuals, high mortality rates are assumed to reduce the expected useful life of MPKs, and this raises concerns regarding their economic effectiveness. OBJECTIVE To investigate the cost-effectiveness and budget impact of the Kenevo/MPK (Ottobock, Germany) compared with non-microprocessor-controlled knees (NMPKs) in people older than 65 years at the time of transfemoral amputation/knee disarticulation, from a Swedish payer's perspective. METHODS A decision-analytic model was developed to conduct the economic analysis of the Kenevo/MPK. Model parameters were derived from Swedish databases and published literature. Univariate and probabilistic sensitivity analyses were performed to explore parameter uncertainty. RESULTS Compared with NMPKs, the Kenevo/MPK reduced the frequency of hospitalizations by 137 per 1,000 person years while the frequency of fatal falls was reduced by 19 per 1,000 person-years in the simulation. Over a 25-year time horizon, the incremental cost-effectiveness ratio was EUR11,369 per quality-adjusted life year. The probability of the MPK being cost-effective at a threshold of EUR40,000 per quality-adjusted life year was 99%. The 5-year budget impact model predicted an increase in payer expenditure of EUR1.76 million if all new patients received a Kenevo/MPK, and 50% of current NMPK users switched to the MPK. CONCLUSIONS Results of the modeling suggest that the Kenevo/MPK is likely to be cost-effective for elderly individuals, primarily because of a reduction in falls.
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Affiliation(s)
| | - Kerstin Hagberg
- Sahlgrenska University Hospital, Gothenburg, Sweden and Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Ilka Kamrad
- Departments of Orthopedics and Clinical Sciences, Lund University and Skåne University Hospital Malmö Sweden
| | | | | | - Hans Berg
- Karolinska University Hospital and Division of Orthopedics and Biotechnology, CLINTEC, Karolinska Institutet, Stockholm, Sweden
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Davie-Smith F, Carse B. Comparison of patient-reported and functional outcomes following transition from mechanical to microprocessor knee in the low-activity user with a unilateral transfemoral amputation. Prosthet Orthot Int 2021; 45:198-204. [PMID: 34016872 DOI: 10.1097/pxr.0000000000000017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/25/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND The Scottish Specialist Prosthetics Service has provided microprocessor knees (MPKs) through the National Health Service since 2014, predominantly to high-activity transfemoral amputations (TFAs). Benefits of MPKs to the lower-activity TFA are less established in the literature. OBJECTIVES This study aimed to compare patient-reported and functional measures in low-activity TFAs transitioning from a mechanical knee to a MPK. STUDY DESIGN This is a retrospective cohort analysis of low-activity individuals with a unilateral TFA provided with an MPK. METHODS Patient-reported measures were recorded in routine clinical care before and 6 months after MPK provision. These included HR-QoL (EQ-5D-5L Health Index), Activities Balance Confidence score, Prosthetic Limb User Survey of Mobility, falls frequency, use of walking aids, and Socket Comfort Score. Functional measures included the two-minute walk test (2MWT), L-test, and Amputee Mobility Predictor score, and three-dimensional gait analysis was used to generate a Gait Profile Score (GPS). The primary outcomes were HR-QoL and GPS. RESULTS Forty-five participants fulfilled the inclusion criteria. Thirty-one had pre-MPK and post-MPK measures, of which 15 had three-dimensional gait analysis. The mean age (n = 31) was 60 years (SD 11), and 68% were male. HR-QoL and GPS did not significantly improve with MPK provision (p = 0.014 and p = 0.019); Amputee Mobility Predictor score, L-Test, 2MWT, falls, and Activities Balance Confidence score showed a significant improvement with MPK provision (p < 0.001). CONCLUSIONS Although no statistically significant change in the primary outcomes was measured, there were sufficient data to support MPK provision in low-activity prosthetic users with participants demonstrating improvements in balance, 2MWT, falls frequency, and confidence.
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Jayaraman C, Mummidisetty CK, Albert MV, Lipschutz R, Hoppe-Ludwig S, Mathur G, Jayaraman A. Using a microprocessor knee (C-Leg) with appropriate foot transitioned individuals with dysvascular transfemoral amputations to higher performance levels: a longitudinal randomized clinical trial. J Neuroeng Rehabil 2021; 18:88. [PMID: 34034753 PMCID: PMC8146219 DOI: 10.1186/s12984-021-00879-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 05/14/2021] [Indexed: 12/02/2022] Open
Abstract
Background Individuals with transfemoral amputations who are considered to be limited community ambulators are classified as Medicare functional classification (MFCL) level K2. These individuals are usually prescribed a non-microprocessor controlled knee (NMPK) with an appropriate foot for simple walking functions. However, existing research suggests that these individuals can benefit from using a microprocessor controlled knee (MPK) and appropriate foot for their ambulation, but cannot obtain one due to insurance policy restrictions. With a steady increase in older adults with amputations due to vascular conditions, it is critical to evaluate whether advanced prostheses can provide better safety and performance capabilities to maintain and improve quality of life in individuals who are predominantly designated MFCL level K2. To decipher this we conducted a 13 month longitudinal clinical trial to determine the benefits of using a C-Leg and 1M10 foot in individuals at K2 level with transfemoral amputation due to vascular disease. This longitudinal clinical trial incorporated recommendations prescribed by the lower limb prosthesis workgroup to design a study that can add evidence to improve reimbursement policy through clinical outcomes using an MPK in K2 level individuals with transfemoral amputation who were using an NMPK for everyday use. Methods Ten individuals (mean age: 63 ± 9 years) with unilateral transfemoral amputation due to vascular conditions designated as MFCL K2 participated in this longitudinal crossover randomized clinical trial. Baseline outcomes were collected with their current prosthesis. Participants were then randomized to one of two groups, either an intervention with the MPK with a standardized 1M10 foot or their predicate NMPK with a standardized 1M10 foot. On completion of the first intervention, participants crossed over to the next group to complete the study. Each intervention lasted for 6 months (3 months of acclimation and 3 months of take-home trial to monitor home use). At the end of each intervention, clinical outcomes and self-reported outcomes were collected to compare with their baseline performance. A generalized linear model ANOVA was used to compare the performance of each intervention with respect to their own baseline. Results Statistically significant and clinically meaningful improvements were observed in gait performance, safety, and participant-reported measures when using the MPK C-Leg + 1M10 foot. Most participants were able to achieve higher clinical scores in gait speed, balance, self-reported mobility, and fall safety, while using the MPK + 1M10 combination. The improvement in scores were within range of scores achieved by individuals with K3 functional level as reported in previous studies. Conclusions Individuals with transfemoral amputation from dysvascular conditions designated MFCL level K2 benefited from using an MPK + appropriate foot. The inference and evidence from this longitudinal clinical trial will add to the knowledgebase related to reimbursement policy-making. Trial registration This study is registered on clinical trials.gov with the study title “Functional outcomes in dysvascular transfemoral amputees” and the associated ClinicalTrials.gov Identifier: NCT01537211. The trial was retroactively registered on February 7, 2012 after the first participant was enrolled. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-021-00879-3.
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Affiliation(s)
- Chandrasekaran Jayaraman
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA.,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Chaithanya K Mummidisetty
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA
| | - Mark V Albert
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA.,Department of Computer Science and Engineering, University of North Texas, Denton, USA.,Department of Biomedical Engineering, University of North Texas, Denton, USA
| | - Robert Lipschutz
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA
| | - Shenan Hoppe-Ludwig
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA
| | - Gayatri Mathur
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA
| | - Arun Jayaraman
- Max Näder Lab for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, USA. .,Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, USA.
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Hobusch GM, Döring K, Brånemark R, Windhager R. Advanced techniques in amputation surgery and prosthetic technology in the lower extremity. EFORT Open Rev 2020; 5:724-741. [PMID: 33204516 PMCID: PMC7608512 DOI: 10.1302/2058-5241.5.190070] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Bone-anchored implants give patients with unmanageable stump problems hope for drastic improvements in function and quality of life and are therefore increasingly considered a viable solution for lower-limb amputees and their orthopaedic surgeons, despite high infection rates.Regarding diversity and increasing numbers of implants worldwide, efforts are to be supported to arrange an international bone-anchored implant register to transparently overview pros and cons.Due to few, but high-quality, articles about the beneficial effects of targeted muscle innervation (TMR) and regenerative peripheral nerve interface (RPNI), these surgical techniques ought to be directly transferred into clinical protocols, observations and routines.Bionics of the lower extremity is an emerging cutting-edge technology. The main goal lies in the reduction of recognition and classification errors in changes of ambulant modes. Agonist-antagonist myoneuronal interfaces may be a most promising start in controlling of actively powered ankle joints.As advanced amputation surgical techniques are becoming part of clinical routine, the development of financing strategies besides medical strategies ought to be boosted, leading to cutting-edge technology at an affordable price.Microprocessor-controlled components are broadly available, and amputees do see benefits. Devices from different manufacturers differ in gait kinematics with huge inter-individual varieties between amputees that cannot be explained by age. Active microprocessor-controlled knees/ankles (A-MPK/As) might succeed in uneven ground-walking. Patients ought to be supported to receive appropriate prosthetic components to reach their everyday goals in a desirable way.Increased funding of research in the field of prosthetic technology could enhance more high-quality research in order to generate a high level of evidence and to identify individuals who can profit most from microprocessor-controlled prosthetic components. Cite this article: EFORT Open Rev 2020;5:724-741. DOI: 10.1302/2058-5241.5.190070.
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Affiliation(s)
- Gerhard M Hobusch
- Medical University of Vienna, Department of Orthopaedics and Trauma Surgery, Vienna, Austria
| | - Kevin Döring
- Medical University of Vienna, Department of Orthopaedics and Trauma Surgery, Vienna, Austria
| | - Rickard Brånemark
- Gothenburg University, Gothenburg, Sweden.,Biomechatronics Group, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Reinhard Windhager
- Medical University of Vienna, Department of Orthopaedics and Trauma Surgery, Vienna, Austria
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Jarvis HL, Reeves ND, Twiste M, Phillip RD, Etherington J, Bennett AN. Can high-functioning amputees with state-of-the-art prosthetics walk normally? A kinematic and dynamic study of 40 individuals. Ann Phys Rehabil Med 2020; 64:101395. [PMID: 32450271 DOI: 10.1016/j.rehab.2020.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Previous work has highlighted the highly functional post-rehabilitation level of military individuals who sustained traumatic amputation. Understanding how these individuals walk with their prosthesis could be key to setting a precedent for what is realistically possible in the rehabilitation of individuals with amputations. OBJECTIVE The aim of this paper is to answer how "normal" should the gait of an individual with an amputation(s) be and can we aspire to mimic able-bodied gait with the most advanced prosthetics in highly functioning individuals? METHODS This was a cross-sectional study comparing the gait of severely injured and highly functional UK trans-tibial (n=10), trans-femoral (n=10) and bilateral trans-femoral (n=10) military amputees after completion of their rehabilitation programme to that of able-bodied controls (n=10). Joint kinematics and kinetics of the pelvis, hip, knee and ankle were measured with 3-D gait analysis during 5min of walking on level ground at a self-selected speed. Peak angle, moment or range of motion of intact and prosthetic limbs were compared to control values. RESULTS Joint kinematics of unilateral trans-tibial amputees was similar to that of controls. Individuals with a trans-femoral amputation walked with a more anterior tilted pelvis (P=0.006), with reduced range of pelvic obliquity (P=0.0023) and ankle plantarflexion (P<0.001) than controls. Across all amputee groups, hip joint moments and power were greater and knee and ankle joint moments were less than for controls. CONCLUSIONS This is the first study to provide a comprehensive description of gait patterns of unilateral trans-tibial, trans-femoral and bilateral trans-femoral amputees as compared with healthy able-bodied individuals. The groups differed in joint kinematics and kinetics, but these can be expected in part because of limitations in prosthesis and socket designs. The results from this study could be considered benchmark data for healthcare professionals to compare gait patterns of other individuals with amputation who experienced similar injuries and rehabilitation services.
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Affiliation(s)
- Hannah L Jarvis
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK; School of Health Sciences, University of Salford, Salford, UK.
| | - Neil D Reeves
- Research Centre for Musculoskeletal Science and Sports Medicine, Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
| | - Martin Twiste
- School of Health Sciences, University of Salford, Salford, UK; United National Institute for Prosthetics & Orthotics Development (UNIPOD), University of Salford, Salford, UK
| | - Rhodri D Phillip
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK
| | - John Etherington
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK
| | - Alexander N Bennett
- Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Headley Court, Epsom, Surrey, UK; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK
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Evaluation of Gait Variable Change over Time as Transtibial Amputees Adapt to a New Prosthesis Foot. BIOMED RESEARCH INTERNATIONAL 2019; 2019:9252368. [PMID: 31236415 PMCID: PMC6545810 DOI: 10.1155/2019/9252368] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/03/2019] [Accepted: 04/22/2019] [Indexed: 11/18/2022]
Abstract
A variety of prescribed accommodation periods have been used in published prosthesis intervention studies that have examined biomechanical outcomes. Few investigators included repeated measurements in their study design, leaving questions as to how measured outcomes change as amputees acclimate to a new prosthesis. This paper is the product of our investigation as to whether measured gait variables were affected by the duration of accommodation period, and to assess the relationship between measured outcomes and the subjective perception of the participants. A sample of transtibial amputees were recruited for this study. Gait data was collected by wearable sensor repeatedly, starting immediately after fitting the interventional foot and extending over a subsequent four days. Participants indicated their perceived accommodation quality on a visual analog scale (VAS). A total of twelve commonly used spatiotemporal gait parameters were analyzed. Friedman tests were used to determine overall differences across time points in both early (one hour) and late (day two through five) accommodation phases, for each gait variable. Statistically significant changes across the early phase were found for variables gait speed χ2(2)=8.000, p=0.018, cadence χ2(2)=7.185, p=0.028, and double support time on the sound side χ2(2)=8.615, p=0.013. Across days two through five, no gait variable significantly changed. VAS scores correlated strongly with step count (r=1.000, p<0.001) and cadence (r=0.857, p=0.014). Longer accommodation periods resulted in less deviations of gait variables for the clinical assessment in the process of prosthetic rehabilitation. Trying out prosthetic interventions for less than one hour has yielded unreliable outcomes.
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