Pushoff Work is Increased Following Prosthesis Adaptation

Abstract:
The purpose of this study was to quantify adaptation to a new prosthesis in terms of mechanical work profiles. Currently, there is a lack of knowledge on how individuals adapt to a new prosthesis, with many studies investigating different prosthetic feet but not adaptation over time. Thus, there is a need for objective measures to quantify the process of adaptation. Mechanical power and work profiles are a prime subject for modern energy-storage-and-return type prostheses, as the amount of energy a prosthesis stores and returns (i.e., positive and negative work) during stance is directly related to how a user loads and unloads the limb. 22 individuals with unilateral, transtibial amputation were given a new prosthesis at their current mobility level (K3 or above) and wore it for a three-week adaptation period. Kinematic and kinetic measures were recorded from walking on overground force plates at 0, 1.5, and 3 weeks into the adaptation period. Positive and negative work done by the prosthesis and intact ankle-foot was calculated using a unified deformable segment model. Positive work from the prosthesis side increased by 6.1% and intact side by 5.7% after 3 weeks (p = .041, .036). No significant changes were seen in negative power from prosthesis or intact side (p = .115, .192). Analyzing work done by a prosthesis may be desirable for tracking a patient’s gait rehabilitation over time. Future work may analyze how mechanical work profiles relate to more traditional clinical measures.
Listed In: Biomechanics, Gait, Physical Therapy,
Tagged In: adaptation, Amputee gait, mechanics, prosthetics
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