@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2016;8(2):75-82
ISSN: 2008-2630 Iranian Journal of War & Public Health 2016;8(2):75-82
Comparison of Ground Reaction Forces Components on Sound and Prosthetic Legs in Trans-Tibial Amputated Individuals
ARTICLE INFO
Article Type
Original ResearchAuthors
Sharifmoradi K. (*)Kamali M. (1)
Karimi M.T. (1)
(*) Physical Education & Sport Science Department, Human Sciences Faculty, University of Kashan, Kashan, Iran
(1) Orthotics & Prosthetics Department, Rehabilitation Faculty, Isfahan University of Medical Sciences, Isfahan , Iran
Correspondence
Address: Kilometer 6 of Ghotb-e-Ravandi Boulevard. University of Kashan, Kashan, Iran. Postal Code: 8731753153Phone: +983155913707
Fax: +983155912543
ksharifmoradi@gmail.com
Article History
Received: December 26, 2015Accepted: May 24, 2016
ePublished: June 18, 2016
ABSTRACT
Aims
The utilization of prosthesis not only changes the gait pattern in the patients with lower-limb amputations, but also applies asymmetrical forces on the limbs leading to disturbances. Therefore, it is very important to identify the application mode of earth’s reaction forces on the lower limbs in walking. The aim of this study was to analyze the components of earth’s reaction forces in healthy leg and prosthetic leg in the patients with unilateral below the knee amputation.
Materials & Methods In the observatory cross-sectional study, 10 patients with unilateral below the knee amputation of rehabilitation clinics of Isfahan were studied in 2013. The subjects were selected via non-probable available sampling method. Qualisys motion analysis system was used to record different gait phases. Kistler force plate was used to measure the earth’s reaction forces. Data was analyzed by SPSS 22 software using independent T test.
Findings In the prosthetic leg, the propulsion impulse (p=0.01) and vertical impulse (p=0.05) of the reaction force of the earth and the loading rate (p=0.03) were lower than the healthy leg by 5.82N/s, 63.25N/s, and 12.8N/s, respectively. Time to peak reaction force of the earth on the prosthetic side was more than the healthy side by 4.9s (p=0.05).There was no significant difference between prosthetic and healthy legs in braking impulse, medio-lateral impulse, peak of braking force, peak of propulsion force, and unloading rate (p>0.05).
Conclusion Greater propulsive impulse, vertical impulse, and loading on the healthy leg than the prosthetic leg in the patients with unilateral below the knee amputation shows that there is a greater loading time interval on the healthy leg.
Materials & Methods In the observatory cross-sectional study, 10 patients with unilateral below the knee amputation of rehabilitation clinics of Isfahan were studied in 2013. The subjects were selected via non-probable available sampling method. Qualisys motion analysis system was used to record different gait phases. Kistler force plate was used to measure the earth’s reaction forces. Data was analyzed by SPSS 22 software using independent T test.
Findings In the prosthetic leg, the propulsion impulse (p=0.01) and vertical impulse (p=0.05) of the reaction force of the earth and the loading rate (p=0.03) were lower than the healthy leg by 5.82N/s, 63.25N/s, and 12.8N/s, respectively. Time to peak reaction force of the earth on the prosthetic side was more than the healthy side by 4.9s (p=0.05).There was no significant difference between prosthetic and healthy legs in braking impulse, medio-lateral impulse, peak of braking force, peak of propulsion force, and unloading rate (p>0.05).
Conclusion Greater propulsive impulse, vertical impulse, and loading on the healthy leg than the prosthetic leg in the patients with unilateral below the knee amputation shows that there is a greater loading time interval on the healthy leg.
CITATION LINKS
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[20]Barr AE, Siegel KL, Danoff JV, McGarvey CL, Tomasko A, Sable I, et al. Biomechanical comparison of the energy-storing capabilities of SACH and Carbon Copy II prosthetic feet during the stance phase of gait in a person with below-knee amputation. Phys Ther. 1992;72(5):344-54.
[21]Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Arch Phys Med Rehabil. 2006;87(10):1334-9.
[22]Esposito ER, Whitehead JMA, Wilken JM. Sound limb loading in individuals with unilateral transfemoral amputation across a range of walking velocities. Clin Biomech. 2015;30(10):1049-55.
[23]Castro MP, Soares D, Mendes E, Machado L. Plantar pressures and ground reaction forces during walking of individuals with unilateral transfemoral amputation. Physic Med Rehabil. 2014;6(8):698-707.
[24]Snyder RD, Powers CM, Fountain C, Perry J. The effect of five prosthetic feet on the gait and loading of the sound limb in dysvascular below-knee amputees. J Rehbil Res Dev. 1995;32(4):309-15.
[25]Arya AP, Lees A, Nerula H, Klenerman L. A biomechanical comparison of the SACH, Seattle and Jaipur feet using ground reaction forces. Prosthet Orthoti Int. 1995;19(1):37-45.
[26]Prince F, Allard P, Therrien R, McFadyen B. Running gait impulse asymmetries in below-knee amputees. Prosthet Orthoti Int. 1992;16(1):19-24.
[27]Kirkwood BR, Sterne JA. Essentials of medical statistics. 2nd edition. London: Blackwell Scientific Publications; 1988.
[28]Richards JG. The measurement of human motion: A comparison of commercially available systems. Hum Mov Sci. 1999;18(5):589-602.
[29]Hall M, Fleming H, Dolan M, Millbank S, Paul J. Static in situ calibration of force plates. J Biomech. 1996; 29(5):659-65.
[30]Papi E, Ugbolue UC, Solomonidis S, Rowe PJ. Comparative study of a newly cluster based method for gait analysis and plug-in gait protocol. Gait Posture. 2014;39(supple 1):S9-10.
[31]Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G, Cochran G. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Aed Res. 1989;7(6):849-60.
[32]Levangie PK, Norkin CC. Joint structure and function: A comprehensive analysis. 5th edition. Philadelphia: F. A. Davis Company; 2011.
[2]Denes Z, Till A. Rehabilitation of patients after hip disarticulation. Arch Orthop Trauma Surg. 1997;116(8):498-9.
[3]Sagawa Y, Turcot K, Armand S, Thevenon A, Vuillerme N, Watelain E. Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review. Gait Posture. 2011;33(4):511-26.
[4]Soares ASOdC, Yamaguti EY, Mochizuki L, Amadio AC, Serrão JC. Biomechanical parameters of gait among transtibial amputees: A review. Sao Paulo Med J. 2009;127(5):302-9.
[5]Pincus T, Burton AK, Vogel S, Field AP. A systematic review of psychological factors as predictors of chronicity/disability in prospective cohorts of low back pain. Spine. 2002;27(5):E109-20.
[6]Devan H, Carman A, Hendrick P, Hale L, Ribeiro DC. Spinal, pelvic, and hip movement asymmetries in people with lower-limb amputation: Systematic review. J Rehabil Res Dev. 2015;52(1):1-20.
[7]Seay JF, Van Emmerik RE, Hamill J. Low back pain status affects pelvis-trunk coordination and variability during walking and running. Clin Biomech. 2011;26(6):572-8
[8]Hendershot BD, Wolf EJ. Three-dimensional joint reaction forces and moments at the low back during over-ground walking in persons with unilateral lower-extremity amputation. Clin Biomech. 2014;29(3):235-42.
[9]Molina Rueda F, Alguacil Diego IM, Molero Sánchez A, Carratalá Tejada M, Rivas Montero FM, Miangolarra Page JC. Knee and hip internal moments and upper-body kinematics in the frontal plane in unilateral transtibial amputees. Gait Posture. 2013;37(3):436-9.
[10]Yoder AJ, Petrella AJ, Silverman AK. Trunk-pelvis motion, joint loads, and muscle forces during walking with a transtibial amputation. Gait Posture. 2015;41(3):757-62.
[11]Morgenroth DC, Orendurff MS, Shakir A, Segal A, Shofer J, Czerniecki JM. The relationship between lumbar spine kinematics during gait and low-back pain in transfemoral amputees. AM J Phys Med Rehabil. 2010;89(8):635-43.
[12]Sadeghi H, Allard P, Duhaime PM. Muscle power compensatory mechanisms in below-knee amputee gait. AM J Phys Med Rehabil. 2001;80(1):25-32.
[13]Silverman AK, Fey NP, Portillo A, Walden JG, Bosker G, Neptune RR. Compensatory mechanisms in below-knee amputee gait in response to increasing steady-state walking speeds. Gait Posture. 2008;28(4):602-9.
[14]Silverman AK, Neptune RR. Three-dimensional knee joint contact forces during walking in unilateral transtibial amputees. J Biomech. 2014;47(11):2556-62.
[15]Hendershot BD, Bazrgari B, Nussbaum MA. Persons with unilateral lower-limb amputation have altered and asymmetric trunk mechanical and neuromuscular behaviors estimated using multidirectional trunk perturbations. J Biomech. 2013;46(11):1907-12.
[16]Kulkarni J, Gaine W, Buckley J, Rankine J, Adams J. Chronic low back pain in traumatic lower limb amputees. Clin Rehabil. 2005;19(1):81-6.
[17]Burke M, Roman V, Wright V. Bone and joint changes in lower limb amputees. Ann Rheum Dis. 1978;37(3):252-4.
[18]Menard MR, McBride ME, Sanderson DJ, Murray DD. Comparative biomechanical analysis of energy-storing prosthetic feet. Arch Phys Med Rehabil. 1992;73(5):451-8.
[19]Mizuno N, Aoyama T, Nakajima A, Kasahara T, Takami K. Functional evaluation by gait analysis of various ankle-foot assemblies used by below-knee amputees. Prosthet Orthoti Int. 1992;16(3):174-82.
[20]Barr AE, Siegel KL, Danoff JV, McGarvey CL, Tomasko A, Sable I, et al. Biomechanical comparison of the energy-storing capabilities of SACH and Carbon Copy II prosthetic feet during the stance phase of gait in a person with below-knee amputation. Phys Ther. 1992;72(5):344-54.
[21]Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Arch Phys Med Rehabil. 2006;87(10):1334-9.
[22]Esposito ER, Whitehead JMA, Wilken JM. Sound limb loading in individuals with unilateral transfemoral amputation across a range of walking velocities. Clin Biomech. 2015;30(10):1049-55.
[23]Castro MP, Soares D, Mendes E, Machado L. Plantar pressures and ground reaction forces during walking of individuals with unilateral transfemoral amputation. Physic Med Rehabil. 2014;6(8):698-707.
[24]Snyder RD, Powers CM, Fountain C, Perry J. The effect of five prosthetic feet on the gait and loading of the sound limb in dysvascular below-knee amputees. J Rehbil Res Dev. 1995;32(4):309-15.
[25]Arya AP, Lees A, Nerula H, Klenerman L. A biomechanical comparison of the SACH, Seattle and Jaipur feet using ground reaction forces. Prosthet Orthoti Int. 1995;19(1):37-45.
[26]Prince F, Allard P, Therrien R, McFadyen B. Running gait impulse asymmetries in below-knee amputees. Prosthet Orthoti Int. 1992;16(1):19-24.
[27]Kirkwood BR, Sterne JA. Essentials of medical statistics. 2nd edition. London: Blackwell Scientific Publications; 1988.
[28]Richards JG. The measurement of human motion: A comparison of commercially available systems. Hum Mov Sci. 1999;18(5):589-602.
[29]Hall M, Fleming H, Dolan M, Millbank S, Paul J. Static in situ calibration of force plates. J Biomech. 1996; 29(5):659-65.
[30]Papi E, Ugbolue UC, Solomonidis S, Rowe PJ. Comparative study of a newly cluster based method for gait analysis and plug-in gait protocol. Gait Posture. 2014;39(supple 1):S9-10.
[31]Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G, Cochran G. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Aed Res. 1989;7(6):849-60.
[32]Levangie PK, Norkin CC. Joint structure and function: A comprehensive analysis. 5th edition. Philadelphia: F. A. Davis Company; 2011.