Evolution of vaulting strategy during locomotion of individuals with transfemoral amputation on slopes and cross-slopes compared to level walking

Autor: Pascale Fodé, Xavier Drevelle, Isabelle Loiret, Hélène Pillet, François Lavaste, Coralie Villa, Xavier Bonnet
Přispěvatelé: Institution Nationale des Invalides - Centre d’Etudes et de Recherche sur l’Appareillage des Handicapés (INI/CERAH), PROTEOR, LBM/institute de Biomécanique humaine Georges Charpak, Arts et Métiers ParisTech, HESAM Université (HESAM)-HESAM Université (HESAM), Institut Régional de Médecine Physique et de Réadaptation Louis Pierquin [Nancy] (IRR Louis Pierquin), HESAM Université (HESAM), Institut de Biomecanique Humaine Georges Charpak, Université Paris 13 (UP13)-Arts et Métiers ParisTech, This study was supported by the French National Research Agency, under reference ANR-2010 TECS-020. The authors are deeply grateful to N. Martinet, J. Paysant, and N. Rapin for their contribution to the study.
Rok vydání: 2015
Předmět:
Zdroj: Clinical Biomechanics
Clinical Biomechanics, Elsevier, 2015, 30 (6), pp.623-628. ⟨10.1016/j.clinbiomech.2015.03.022⟩
ISSN: 0268-0033
1879-1271
DOI: 10.1016/j.clinbiomech.2015.03.022
Popis: Background: Vaulting is a walking strategy qualitatively characterized in clinics by the sound ankle plantiflexion in midstance to assist prosthetic foot clearance. Even though potentially harmful, this strategy is often observed among people with transfemoral amputation to secure clearance of the prosthetic limb during swing phase. The aim of the study is to provide a quantitative analysis of the evolution of the vaulting strategy in challenging situations of daily living. Methods: 17 persons with transfemoral amputation and 17 able-bodied people participated in the study. Kinematic and kinetic gait analyses were performed for level walking, 10% inclined cross-slope walking, 5% and 12% inclined slope ascending. To study vaulting strategy, peak of generated power at the sound ankle at midstance was identified and quantified in the different walking situations. In particular, values were compared to a vaulting threshold corresponding to a peak of generated power superior to 0.15 W/kg. Findings: The vaulting threshold was exceeded for a larger proportion of people with amputation during crossslope locomotion and slope ascent than during level walking. In addition, magnitude of the peak of generated power increased significantly compared to level walking in these situations. Interpretation: Vaulting seems to be widely used by patients with transfemoral amputation in daily living situations.The number of patients using vaulting increased with the difficulty of the walking situation. Results also suggested that patients could dose the amount of vaulting according to gait environment to secure prosthetic toe clearance. During rehabilitation, vaulting should also be corrected or prevented in daily living tasks. This study was supported by the French National Research Agency, under reference ANR-2010 TECS-020. The authors are deeply grateful to N. Martinet, J. Paysant, and N. Rapin for their contribution to the study.
Databáze: OpenAIRE
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