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Pelvic obliquity as a compensatory mechanism leading to lower energy recovery: Characterization among the types of prostheses in subjects with transfemoral amputation.
- Source :
-
Gait & posture [Gait Posture] 2020 Jul; Vol. 80, pp. 280-284. Date of Electronic Publication: 2020 Jun 12. - Publication Year :
- 2020
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Abstract
- 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.<br />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.<br />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.<br />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.<br />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.<br />Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest<br /> (Copyright © 2020 Elsevier B.V. All rights reserved.)
- Subjects :
- Adaptation, Physiological
Adult
Aged
Biomechanical Phenomena
Gait
Humans
Male
Middle Aged
Recovery of Function
Walking
Amputation, Surgical adverse effects
Amputation, Surgical rehabilitation
Artificial Limbs
Femur surgery
Gait Disorders, Neurologic etiology
Gait Disorders, Neurologic physiopathology
Pelvis pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1879-2219
- Volume :
- 80
- Database :
- MEDLINE
- Journal :
- Gait & posture
- Publication Type :
- Academic Journal
- Accession number :
- 32563728
- Full Text :
- https://doi.org/10.1016/j.gaitpost.2020.06.013