Mechanisms to absorb load in amputee running

Background: We aimed to determine if a shock absorbing pylon (SAP) influenced the ground reaction force characteristics and the shock absorbing mechanisms compared to a rigid pylon (Rigid) during the loading phase in running. Objectives: To determine if the SAP influences the mechanisms of loading compared to the Rigid condition. Study Design: A convenience sample of transtibial amputees participated in a laboratory-based study. The prosthetic set-up was randomly altered fd\sdsd. Methods: Five recreationally active male transtibial amputees age: 18–50 years; mean mass: 86.7 ± 17.5 kg; height: 1.77 ± 0.07 m) volunteered from a population-based sample. They completed a within-participant-designed study assessing a SAP and a Rigid condition during running. Kinematic and kinetic data were collected during two sessions following a one-week customization period. Results: Loading rate, peak vertical and horizontal ground reaction forces and the time to each measure along with knee and hip angular displacement, absorbing powers and work done between the SAP and Rigid conditions were not systematically affected by the prosthetic condition. Conclusions: The effect of the SAP was minimal and inconsistent in the loading phase, with only some amputees presenting higher and others with lower values for the tested variables. Clinical relevance The inclusion of a prosthetic shock absorber in the form of a SAP did not systematically alter the kinetic characteristics or shock absorbing mechanisms of the residual joints. It appears that the prescription of a SAP is not justified for these recreationally active amputees.

[1]  D S Childress,et al.  A review of prosthetic interface stress investigations. , 1996, Journal of rehabilitation research and development.

[2]  R Dumas,et al.  Loading applied on prosthetic knee of transfemoral amputee: comparison of inverse dynamics and direct measurements. , 2009, Gait & posture.

[3]  H. Handoll,et al.  Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. , 2005, The Cochrane database of systematic reviews.

[4]  Shawn C Marshall,et al.  Dermatologic conditions associated with use of a lower-extremity prosthesis. , 2005, Archives of physical medicine and rehabilitation.

[5]  M. Whittle,et al.  Influence of gait parameters on the loading of the lower limb. , 1989, Journal of biomedical engineering.

[6]  J G Buckley.  Biomechanical adaptations of transtibial amputee sprinting in athletes using dedicated prostheses. , 2000, Clinical biomechanics.

[7]  D. Kerwin,et al.  Lower-limb mechanics during the support phase of maximum-velocity sprint running. , 2008, Medicine and science in sports and exercise.

[8]  A. J. van den Bogert,et al.  Direct dynamics simulation of the impact phase in heel-toe running. , 1995, Journal of biomechanics.

[9]  Peter R. Cavanagh,et al.  Biomechanics of Distance Running. , 1990 .

[10]  L. Dugdill,et al.  Health professionals' perspectives in exercise referral: implications for the referral process , 2005, Ergonomics.

[11]  T. Derrick.  The effects of knee contact angle on impact forces and accelerations. , 2004, Medicine and science in sports and exercise.

[12]  Angus K McFadyen,et al.  Physical activity and quality of life: A study of a lower-limb amputee population , 2008, Prosthetics and orthotics international.

[13]  Tim W Dorn,et al.  Effect of running speed on lower limb joint kinetics. , 2011, Medicine and science in sports and exercise.

[14]  Richard A. Brand,et al.  The biomechanics and motor control of human gait: Normal, elderly, and pathological , 1992 .

[15]  R. B. Davis,et al.  A gait analysis data collection and reduction technique , 1991 .

[16]  Herman J. Woltring,et al.  A fortran package for generalized, cross-validatory spline smoothing and differentiation , 1986 .

[17]  S. Gard,et al.  The effect of a shock-absorbing pylon on the gait of persons with unilateral transtibial amputation. , 2003, Journal of rehabilitation research and development.

[18]  Mark R Pitkin.  Effects of Design Variants in Lower‐Limb Prostheses on Gait Synergy , 1997, Journal of prosthetics and orthotics : JPO.

[19]  A. Arampatzis,et al.  The effect of speed on leg stiffness and joint kinetics in human running. , 1999, Journal of biomechanics.

[20]  D. Sanderson,et al.  Joint kinetics in unilateral below-knee amputee patients during running. , 1996, Archives of physical medicine and rehabilitation.

[21]  J. Czerniecki,et al.  Prosthetic intervention effects on activity of lower-extremity amputees. , 2006, Archives of physical medicine and rehabilitation.

[22]  A. Lees,et al.  The functional demands on the intact limb during walking for active transfemoral and transtibial amputees , 2000, Prosthetics and orthotics international.

[23]  Joseph M Czerniecki,et al.  Efficacy of shock-absorbing versus rigid pylons for impact reduction in transtibial amputees based on laboratory, field, and outcome metrics. , 2005, Journal of rehabilitation research and development.

[24]  P. E. Martin,et al.  Walking symmetry and energy cost in persons with unilateral transtibial amputations: matching prosthetic and intact limb inertial properties. , 2000, Archives of physical medicine and rehabilitation.