Dynamic gait stability and stability symmetry for people with transfemoral amputation: A case-series of 19 individuals with bone-anchored limbs.

Autor: Tracy JB; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Veteran's Affairs Eastern Colorado Healthcare System, Aurora, CO, USA. Electronic address: james.tracy@cuanschutz.edu., Gaffney BMM; Veteran's Affairs Eastern Colorado Healthcare System, Aurora, CO, USA; Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, USA; Center for Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Thomsen PB; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Veteran's Affairs Eastern Colorado Healthcare System, Aurora, CO, USA., Awad ME; Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Melton DH; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA., Christiansen CL; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Veteran's Affairs Eastern Colorado Healthcare System, Aurora, CO, USA., Stoneback JW; Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Jazyk: angličtina
Zdroj: Journal of biomechanics [J Biomech] 2024 Jun; Vol. 171, pp. 112208. Date of Electronic Publication: 2024 Jun 25.
DOI: 10.1016/j.jbiomech.2024.112208
Abstrakt: For some individuals with severe socket-related problems, prosthesis osseointegration directly connects a prosthesis to the residual limb creating a bone-anchored limb (BAL). We compared dynamic gait stability and between-limb stability symmetry, as measured by the Margin of Stability (MoS) and the Normalized Symmetry Index (NSI), for people with unilateral transfemoral amputation before and one-year after BAL implantation. The MoS provides a mechanical construct to assess dynamic gait stability and infer center of mass and limb control by relating the center of mass and velocity to the base of support. Before and one-year after BAL implantation, 19 participants walked overground at self-selected speeds. We quantified dynamic gait stability anteriorly and laterally at foot strike and at the minimum lateral MoS value. After implantation, we observed decreased lateral MoS at foot strike for the amputated (MoS mean(SD) %height; pre: 6.6(2.3), post: 5.9(1.3), d = 0.45) and intact limb (pre: 6.2(1.2), post: 5.8(1.0), d = 0.38) and increased between-limb MoS symmetry at foot strike (NSI mean(SD) %; anterior-pre: 10.3(7.3), post: 8.4(3.6), d = 0.23; lateral-pre: 18.8(12.4), post: 12.4(4.9), d = 0.47) and at minimum lateral stability (pre: 28.1(18.1), post: 19.2(6.8), d = 0.50). Center of mass control using a BAL resulted in dynamic gait stability more similar between limbs and may have reduced the adoption of functional asymmetries. We suggest that improved between-limb MoS symmetry after BAL implantation is likely due to subtle changes in individual limb MoS values at self-selected walking speeds resulting in an overall positive impact on fall risk through improved center of mass and prosthetic limb control.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Dr. Jason W. Stoneback is a paid consultant for AQ Solutions. No additional competing financial or non-financial interests which could or appear to influence the interpretation or presentation of this work are declared].
(Published by Elsevier Ltd.)
Databáze: MEDLINE
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