Transhumeral prosthesis use affects upper body kinematics and kinetics.

Autor: Dunn JA; Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA., Gomez NG; Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; College of Health, Human Services & Nursing California State University, 1000 E. Victoria Street, Carson, CA 90747, USA., Wong B; College of Nursing University of Utah, 10 2000 E, Salt Lake City, UT 84112, USA., Sinclair SK; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA., Henninger HB; Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA., Foreman KB; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA., Bachus KN; Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, UT 84148, USA. Electronic address: kent.bachus@hsc.utah.edu.
Jazyk: angličtina
Zdroj: Gait & posture [Gait Posture] 2024 Jul; Vol. 112, pp. 59-66. Date of Electronic Publication: 2024 May 11.
DOI: 10.1016/j.gaitpost.2024.05.007
Abstrakt: Background: Transhumeral (TH) limb loss leads to loss of body mass and reduced shoulder range of motion. Despite most owning a prosthesis, prosthesis abandonment is common. The consequence of TH limb loss and prosthesis use and disuse during gait may be compensation in the upper body, contributing to back pain or injury. Understanding the impact of not wearing a TH prosthesis on upper body asymmetries and spatial-temporal aspects of gait will inform how TH prosthesis use and disuse affects the body.
Research Question: Does TH limb loss alter upper body asymmetries and spatial-temporal parameters during gait when wearing and not wearing a prosthesis compared to able-bodied controls?
Methods: Eight male TH limb loss participants and eight male control participants completed three gait trials at self-selected speeds. The TH limb loss group performed trials with and without their prosthesis. Arm swing, trunk angular displacement, trunk-pelvis moment, and spatial-temporal aspects were compared using non-parametric statistical analyses.
Results: Both TH walking conditions showed greater arm swing in the intact limb compared to the residual (p≤0.001), resulting in increased asymmetry compared to the control group (p≤0.001). Without the prosthesis, there was less trunk flexion and lateral flexion compared to the control group (p≤0.001). Maximum moments between the trunk and pelvis were higher in the TH group than the control group (p≤0.05). Spatial-temporal parameters of gait did not differ between the control group and either TH limb loss condition.
Significance: Prosthesis use affects upper body kinematics and kinetics, but does not significantly impact spatial-temporal aspects of gait, suggesting these are compensatory actions. Wearing a prosthesis helps achieve more normative upper body kinematics and kinetics than not wearing a prosthesis, which may help limit back pain. These findings emphasize the importance of encouraging at least passive use of prostheses for individuals with TH limb loss.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Kent N. Bachus reports financial support was provided by Department of Veterans Affairs. Sarina K. Sinclair reports financial support was provided by Department of Veterans Affairs. Julia A. Dunn reports financial support was provided by National Science Foundation. Nicholas G. Gomez reports a relationship with Biomechanics Advanced that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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