joint loading

Joint loading during graded walking with different prostheses - a case study

For lower limb amputees graded walking imposes a high level of motor ability, due to the missing proprioceptive feedback of the limb, and the necessary compensation mechanisms. In order to facilitate gait a focus in prosthesis research is the development of the prostheses ankle joints from rigid to moveable. Therefore, the aim of this case study was to analyse the effects of three different prostheses with a rigid and a moveable ankle joint during graded walking of a unilateral amputee. One male unilateral transfemoral amputee was recruited for this study and a comparison of following three prostheses (endolite, Germany) was performed: Elan (movable ankle joint with flexible resistance), Echelon (movable ankle joint with steady resistance) and Esprit (rigid ankle joint). Kinematic (12 cameras, Vicon, UK, 250 Hz) and kinetic (2 force plates, AMTI, MA, 1000 Hz) data were recorded during self-paced walking on a 6 m ramp, which was set to the inclinations of -12°, -4°, 0°, 4° and 12°. Following gait parameters, ground reaction forces, joint angles and joint moments were calculated. Gait parameters, ground reaction forces and joint angles were marginally influenced by the different prosthetic designs, but major changes occurred on the joint moment level. The use of the rigid ankle prosthesis Esprit induced up to 10 times higher joint moments compared to the moveable ankle joint prostheses. This case study showed that a moveable ankle joint can reduce the joint moments during graded walking, which might be advantageous to use for transfemoral amputees in graded walking.
Listed In: Biomechanics, Gait