Benefits of a microprocessor-controlled prosthetic foot for ascending and descending slopes.


Journal

Journal of neuroengineering and rehabilitation
ISSN: 1743-0003
Titre abrégé: J Neuroeng Rehabil
Pays: England
ID NLM: 101232233

Informations de publication

Date de publication:
28 01 2022
Historique:
received: 25 01 2021
accepted: 03 01 2022
entrez: 29 1 2022
pubmed: 30 1 2022
medline: 22 3 2022
Statut: epublish

Résumé

Prosthetic feet are prescribed for persons with a lower-limb amputation to restore lost mobility. However, due to limited adaptability of their ankles and springs, situations like walking on slopes or uneven ground remain challenging. This study investigated to what extent a microprocessor-controlled prosthetic foot (MPF) facilitates walking on slopes. Seven persons each with a unilateral transtibial amputation (TTA) and unilateral transfemoral amputation (TFA) as well as ten able-bodied subjects participated. Participants were studied while using a MPF and their prescribed standard feet with fixed ankle attachments. The study investigated ascending and descending a 10° slope. Kinematic and kinetic data were recorded with a motion capture system. Biomechanical parameters, in particular leg joint angles, shank orientation and external joint moments of the prosthetics side were calculated. Prosthetic feet- and subject group-dependent joint angle and moment characteristics were observed for both situations. The MPF showed a larger and situation-dependent ankle range of motion compared to the standard feet. Furthermore, it remained in a dorsiflexed position during swing. While ascending, the MPF adapted the dorsiflexion moment and reduced the knee extension moment. At vertical shank orientation, it reduced the knee extension moment by 26% for TFA and 49% for TTA compared to the standard feet. For descending, differences between feet in the biomechanical knee characteristics were found for the TTA group, but not for the TFA group. At the vertical shank angle during slope descent, TTA demonstrated a behavior of the ankle moment similar to able-bodied controls when using the MPF. The studied MPF facilitated walking on slopes by adapting instantaneously to inclinations and, thus, easing the forward rotation of the leg over the prosthetic foot compared to standard feet with a fixed ankle attachment with amputation-level dependent effect sizes. It assumed a dorsiflexed ankle angle during swing, enabled a larger ankle range of motion and reduced the moments acting on the residual knee of TTA compared to the prescribed prosthetic standard feet. For individuals with TFA, the prosthetic knee joint seems to play a more crucial role for walking on ramps than the foot.

Sections du résumé

BACKGROUND
Prosthetic feet are prescribed for persons with a lower-limb amputation to restore lost mobility. However, due to limited adaptability of their ankles and springs, situations like walking on slopes or uneven ground remain challenging. This study investigated to what extent a microprocessor-controlled prosthetic foot (MPF) facilitates walking on slopes.
METHODS
Seven persons each with a unilateral transtibial amputation (TTA) and unilateral transfemoral amputation (TFA) as well as ten able-bodied subjects participated. Participants were studied while using a MPF and their prescribed standard feet with fixed ankle attachments. The study investigated ascending and descending a 10° slope. Kinematic and kinetic data were recorded with a motion capture system. Biomechanical parameters, in particular leg joint angles, shank orientation and external joint moments of the prosthetics side were calculated.
RESULTS
Prosthetic feet- and subject group-dependent joint angle and moment characteristics were observed for both situations. The MPF showed a larger and situation-dependent ankle range of motion compared to the standard feet. Furthermore, it remained in a dorsiflexed position during swing. While ascending, the MPF adapted the dorsiflexion moment and reduced the knee extension moment. At vertical shank orientation, it reduced the knee extension moment by 26% for TFA and 49% for TTA compared to the standard feet. For descending, differences between feet in the biomechanical knee characteristics were found for the TTA group, but not for the TFA group. At the vertical shank angle during slope descent, TTA demonstrated a behavior of the ankle moment similar to able-bodied controls when using the MPF.
CONCLUSIONS
The studied MPF facilitated walking on slopes by adapting instantaneously to inclinations and, thus, easing the forward rotation of the leg over the prosthetic foot compared to standard feet with a fixed ankle attachment with amputation-level dependent effect sizes. It assumed a dorsiflexed ankle angle during swing, enabled a larger ankle range of motion and reduced the moments acting on the residual knee of TTA compared to the prescribed prosthetic standard feet. For individuals with TFA, the prosthetic knee joint seems to play a more crucial role for walking on ramps than the foot.

Identifiants

pubmed: 35090505
doi: 10.1186/s12984-022-00983-y
pii: 10.1186/s12984-022-00983-y
pmc: PMC8796559
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

9

Informations de copyright

© 2022. The Author(s).

Références

Gait Posture. 2008 Aug;28(2):235-42
pubmed: 18242995
Am J Phys Med Rehabil. 2010 Jan;89(1):34-47
pubmed: 20026945
PLoS One. 2016 Dec 15;11(12):e0166815
pubmed: 27977681
J Rehabil Res Dev. 2014;51(8):1229-42
pubmed: 25625226
IEEE Trans Neural Syst Rehabil Eng. 2018 Apr;26(4):788-797
pubmed: 29641383
Prosthet Orthot Int. 2016 Jun;40(3):311-9
pubmed: 25628378
Gait Posture. 2019 Feb;68:161-167
pubmed: 30497035
Arch Orthop Trauma Surg. 2001 Jun;121(6):307-12
pubmed: 11482460
J Neuroeng Rehabil. 2017 Nov 16;14(1):117
pubmed: 29145876
J Rehabil Res Dev. 2014;51(3):429-37
pubmed: 25019665
Sci Rep. 2018 Mar 29;8(1):5354
pubmed: 29599517
PLoS One. 2018 Oct 5;13(10):e0205093
pubmed: 30289921
J Neuroeng Rehabil. 2018 Sep 5;15(Suppl 1):76
pubmed: 30255807
Prosthet Orthot Int. 2018 Jun;42(3):350-356
pubmed: 29400252
PLoS One. 2017 Mar 9;12(3):e0173423
pubmed: 28278172
Gait Posture. 2018 Jul;64:174-180
pubmed: 29913354
J Neuroeng Rehabil. 2019 Mar 14;16(1):39
pubmed: 30871573
Scand J Rehabil Med Suppl. 1983;9:150-62
pubmed: 6585937
J Biomech. 2019 Oct 11;95:109273
pubmed: 31431348
Clin Biomech (Bristol, Avon). 2016 Feb;32:164-70
pubmed: 26689894
Arch Phys Med Rehabil. 2012 Mar;93(3):541-9
pubmed: 22373937
Clin Biomech (Bristol, Avon). 2015 Feb;30(2):175-81
pubmed: 25537443
J Rehabil Res Dev. 2014;51(10):1579-90
pubmed: 25860285
Proc Inst Mech Eng H. 2021 Jul;235(7):762-769
pubmed: 33784889
Hum Mov Sci. 2007 Aug;26(4):617-56
pubmed: 17617481
Prosthet Orthot Int. 2015 Oct;39(5):380-9
pubmed: 24925671
Arch Phys Med Rehabil. 1994 Jul;75(7):825-9
pubmed: 8024435
Arch Phys Med Rehabil. 2010 Apr;91(4):644-52
pubmed: 20382300
J Exp Psychol Gen. 2012 Feb;141(1):2-18
pubmed: 21823805
Gait Posture. 2010 Jun;32(2):191-8
pubmed: 20457526
J Rehabil Assist Technol Eng. 2018 Oct 08;5:2055668318790650
pubmed: 31191949
Clin Biomech (Bristol, Avon). 2018 Aug;57:35-41
pubmed: 29908391
Clin Biomech (Bristol, Avon). 2011 Dec;26(10):1025-32
pubmed: 21777999

Auteurs

Michael Ernst (M)

Research Biomechanics, CR&S, Ottobock SE & Co. KGaA, Göttingen, Germany. michael.ernst@ottobock.de.

Björn Altenburg (B)

Research Biomechanics, CR&S, Ottobock SE & Co. KGaA, Göttingen, Germany.

Thomas Schmalz (T)

Research Biomechanics, CR&S, Ottobock SE & Co. KGaA, Göttingen, Germany.

Andreas Kannenberg (A)

Medical Affairs, Otto Bock Healthcare LP, Austin, USA.

Malte Bellmann (M)

Research Biomechanics, CR&S, Ottobock SE & Co. KGaA, Göttingen, Germany.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH