Pelvic obliquity as a compensatory mechanism leading to lower energy recovery: Characterization among the types of prostheses in subjects with transfemoral amputation.
Energetic gait parameters
Lower limb amputation
Pelvic obliquity
Prosthetic gait
Journal
Gait & posture
ISSN: 1879-2219
Titre abrégé: Gait Posture
Pays: England
ID NLM: 9416830
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
17
03
2020
revised:
08
06
2020
accepted:
10
06
2020
pubmed:
22
6
2020
medline:
30
3
2021
entrez:
22
6
2020
Statut:
ppublish
Résumé
Subjects with transfemoral amputation (TFA) show an asymmetric gait pattern associated with a decreased ability to recover mechanical energy and an increased metabolic cost of walking. This study aimed to identify the spatio-temporal and kinematic gait variables correlated with mechanical energy values in subjects with TFA and to observe the ability of the identified parameters to discriminate between TFA and controls according to the type of prosthesis. The gait of 40 subjects with TFA was evaluated with a motion 3-D optoelectronic system. Nine subjects wore a mechanical prosthesis (TFAm), seventeen a C-Leg prosthesis (TFAc), and fourteen a Genium prosthesis (TFAg). Spatio-temporal and pelvic kinematic parameters were measured. Energy recovery was measured relative to the whole-body center of mass (CoM) kinematics as the fraction of mechanical energy recovered during each walking step (R-step). Correlation tests and multiple linear regression analyses were used to evaluate the correlation and association between kinematic and energy variables, respectively. Receiver operating characteristics curves were plotted to assess the ability of the correlated parameter to distinguish subjects with TFA from controls, and optimal cutoff point values were calculated according to the type of prosthesis. Among the spatio-temporal and kinematic parameters correlated to R-step, only pelvic obliquity of the prosthetic side was significantly associated with R-step. It showed an excellent ability to discriminate between TFA and controls. Furthermore, pelvic obliquity showed an excellent discriminative ability in identifying TFAm and TFAc and a good discriminative ability in identifying TFAg from controls. Pelvic obliquity plays an important role in energy recovery during gait for subjects using prosthetics. This information might be exploited to monitor the adaptation of subjects with TFA to prosthetic devices, to lower the energetic cost of walking potentially, and to reduce the long-term risks of secondary physical complications in prosthetic users.
Sections du résumé
BACKGROUND
Subjects with transfemoral amputation (TFA) show an asymmetric gait pattern associated with a decreased ability to recover mechanical energy and an increased metabolic cost of walking.
RESEARCH QUESTION
This study aimed to identify the spatio-temporal and kinematic gait variables correlated with mechanical energy values in subjects with TFA and to observe the ability of the identified parameters to discriminate between TFA and controls according to the type of prosthesis.
METHODS
The gait of 40 subjects with TFA was evaluated with a motion 3-D optoelectronic system. Nine subjects wore a mechanical prosthesis (TFAm), seventeen a C-Leg prosthesis (TFAc), and fourteen a Genium prosthesis (TFAg). Spatio-temporal and pelvic kinematic parameters were measured. Energy recovery was measured relative to the whole-body center of mass (CoM) kinematics as the fraction of mechanical energy recovered during each walking step (R-step). Correlation tests and multiple linear regression analyses were used to evaluate the correlation and association between kinematic and energy variables, respectively. Receiver operating characteristics curves were plotted to assess the ability of the correlated parameter to distinguish subjects with TFA from controls, and optimal cutoff point values were calculated according to the type of prosthesis.
RESULTS
Among the spatio-temporal and kinematic parameters correlated to R-step, only pelvic obliquity of the prosthetic side was significantly associated with R-step. It showed an excellent ability to discriminate between TFA and controls. Furthermore, pelvic obliquity showed an excellent discriminative ability in identifying TFAm and TFAc and a good discriminative ability in identifying TFAg from controls.
SIGNIFICANCE
Pelvic obliquity plays an important role in energy recovery during gait for subjects using prosthetics. This information might be exploited to monitor the adaptation of subjects with TFA to prosthetic devices, to lower the energetic cost of walking potentially, and to reduce the long-term risks of secondary physical complications in prosthetic users.
Identifiants
pubmed: 32563728
pii: S0966-6362(20)30214-9
doi: 10.1016/j.gaitpost.2020.06.013
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
280-284Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that there are no conflicts of interest