1
|
Manz S, Seifert D, Altenburg B, Schmalz T, Dosen S, Gonzalez-Vargas J. Using embedded prosthesis sensors for clinical gait analyses in people with lower limb amputation: A feasibility study. Clin Biomech (Bristol, Avon) 2023; 106:105988. [PMID: 37230008 DOI: 10.1016/j.clinbiomech.2023.105988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Biomechanical gait analyses are typically performed in laboratory settings, and are associated with limitations due to space, marker placement, and tasks that are not representative of the real-world usage of lower limb prostheses. Therefore, the purpose of this study was to investigate the possibility of accurately measuring gait parameters using embedded sensors in a microprocessor-controlled knee joint. METHODS Ten participants were recruited for this study and equipped with a Genium X3 prosthetic knee joint. They performed level walking, stair/ramp descent, and ascent. During these tasks, kinematics and kinetics (sagittal knee and thigh segment angle, and knee moment) were recorded using an optical motion capture system and force plates (gold standard), as well as the prosthesis-embedded sensors. Root mean square errors, relative errors, correlation coefficients, and discrete outcome variables of clinical relevance were calculated and compared between the gold standard and the embedded sensors. FINDINGS The average root mean square errors were found to be 0.6°, 5.3°, and 0.08 Nm/kg, for the knee angle, thigh angle, and knee moment, respectively. The average relative errors were 0.75% for the knee angle, 11.67% for the thigh angle, and 9.66%, for the knee moment. The discrete outcome variables showed small but significant differences between the two measurement systems for a number of tasks (higher differences only at the thigh). INTERPRETATION The findings highlight the potential of prosthesis-embedded sensors to accurately measure gait parameters across a wide range of tasks. This paves the way for assessing prosthesis performance in realistic environments outside the lab.
Collapse
Affiliation(s)
- Sabina Manz
- Ottobock SE & Co. KGaA, Duderstadt, Germany; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
| | | | | | | | - Strahinja Dosen
- Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | |
Collapse
|
2
|
Demeco A, Frizziero A, Nuresi C, Buccino G, Pisani F, Martini C, Foresti R, Costantino C. Gait Alteration in Individual with Limb Loss: The Role of Inertial Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:1880. [PMID: 36850475 PMCID: PMC9964846 DOI: 10.3390/s23041880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/01/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Amputation has a big impact on the functioning of patients, with negative effects on locomotion and dexterity. In this context, inertial measurement units represent a useful tool in clinical practice for motion analysis, and in the development of personalized aids to improve a patient's function. To date, there is still a gap of knowledge in the scientific literature on the application of inertial sensors in amputee patients. Thus, the aim of this narrative review was to collect the current knowledge on this topic and stimulate the publication of further research. Pubmed, Embase, Scopus, and Cochrane Library publications were screened until November 2022 to identify eligible studies. Out of 444 results, we selected 26 articles focused on movement analysis, risk of falls, energy expenditure, and the development of sensor-integrated prostheses. The results showed that the use of inertial sensors has the potential to improve the quality of life of patients with prostheses, increasing patient safety through the detection of gait alteration; enhancing the socio-occupational reintegration through the development of highly technologic and personalized prosthesis; and by monitoring the patients during daily life to plan a tailored rehabilitation program.
Collapse
Affiliation(s)
- Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Christian Nuresi
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Giovanni Buccino
- Division of Neuroscience, IRCCS San Raffaele, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Francesco Pisani
- Department of Human Neuroscience, University la Sapienza Rome, 00185 Rome, Italy
| | - Chiara Martini
- Department of Diagnostic, Parma University Hospital, 43126 Parma, Italy
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| |
Collapse
|
3
|
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.
Collapse
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,
| |
Collapse
|
4
|
Xu R, Zuo H, Ji Y, Li Q, Wang Z, Liu H, Wang J, Wei Z, Li W, Cong L, Li H, Jin H, Wang J. Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking. Med Sci Monit 2021; 27:e930081. [PMID: 33664219 PMCID: PMC7941761 DOI: 10.12659/msm.930081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We analyzed the effect of limitation of movement of the first metatarsophalangeal joint (FMJ) on the biomechanics of the lower limbs during walking. MATERIAL AND METHODS Eight healthy college students completed walking under barefoot (BF) and FMJ constraint (FMJC) conditions. We synchronously collected kinematics and dynamics data, and calculated the torque, power, and work of hip, knee, and ankle joints. RESULTS Compared with normal conditions, when the FMJ is restricted from walking, the maximum ankle dorsiflexion angle is significantly increased (P<0.001), the maximum plantar flexion angle is significantly reduced (P<0.001), the maximum plantar flexion torque (P<0.001) and the maximum dorsiflexion torque (P<0.05) increased significantly, the maximum power increased significantly (P<0.001), the minimum power decreased significantly (P<0.001), and the negative work increased significantly (P<0.001). The torque of hip and knee joints increased significantly (P<0.05). CONCLUSIONS After the movement of the FMJ is restricted, the human body mainly compensates and transfers compensation by increasing the angle of dorsiflexion, increasing work and the activity level of surrounding muscles through the ankle joint, thereby increasing the torque load of the knee and hip joints to maintain the dynamic balance of kinematics. FMJC condition increases the energy consumption of the human ankle, knee, and hip joints during walking. The load is compensated by the gradual attenuation of the ankle, knee, and hip. Long-term limitation may cause damage to the posterior calf muscles and increase the incidence of knee arthritis.
Collapse
Affiliation(s)
- Rui Xu
- Department of Endocrinology, Shanghai National Research Center for Endocrine and Metabolic Disease, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Disease, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).,Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Hao Zuo
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Youbo Ji
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Qiang Li
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Zhonghan Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - He Liu
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Jiarui Wang
- Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Zheyi Wei
- Department of Clinical Medicine, Fudan University School of Medicine, Shanghai, China (mainland)
| | - Weihang Li
- Department of Orthopaedics, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Lin Cong
- Department of Bioengineering, School of Public Health, Jilin University, Changchun, Jilin, China (mainland)
| | - Han Li
- Department of Clinical Medicine, Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China (mainland)
| | - Hui Jin
- Department of Pain, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| | - Jincheng Wang
- Orthopaedic Medical Centre, The Second Hospital of Jilin University, Changchun, Jilin, China (mainland)
| |
Collapse
|
5
|
Durand J, Prat A, Provot T, Bascou J, Simonetti E. Identification of gait stability indices for the rehabilitation follow-up of people with transtibial amputation: a preliminary study. Comput Methods Biomech Biomed Engin 2020. [DOI: 10.1080/10255842.2020.1812172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- J. Durand
- Institution nationale des Invalides (INI)/CERAH, Créteil, France
| | - A. Prat
- Institution nationale des Invalides (INI)/CERAH, Créteil, France
| | - T. Provot
- EPF – Graduate School of Engineering, 3 bis rue Lakanal, Sceaux, France
- Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - J. Bascou
- Institution nationale des Invalides (INI)/CERAH, Créteil, France
- Institut de Biomécanique Humaine Georges Charpak, Paris, France
| | - E. Simonetti
- Institution nationale des Invalides (INI)/CERAH, Créteil, France
- Institut de Biomécanique Humaine Georges Charpak, Paris, France
- University of Rome "Foro Italico", Rome, Italy
| |
Collapse
|