• Title/Summary/Keyword: Transfemoral Amputee

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Analysis of Joint Moment in the Intact Limb With Uni-Transfemoral Amputee During Level Walking (편측 대퇴절단자의 보행 시 건측 하지 관절 모멘트 분석)

  • Chang, Yun-Hee;Lee, Wan-Hee
    • Physical Therapy Korea
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    • v.15 no.2
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    • pp.64-72
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    • 2008
  • The purpose of this study was to determine the differences in joint moment in the intact limb of uni-transfemoral amputees and to identify the implications of knee osteoarthritis. As an experimental method, three-dimensional gait analysis was performed on 10 uni-transfemoral amputees and 10 healthy males. Kinematics and kinetics at the hip, knee, and ankle joint were calculated. As a statistical method, independent t-tests were conducted to perform a comparison between the transfemoral amputee group and the control group. The results showed that the external knee adduction moment increased in the transfemoral amputee group (.22 Nm/kg) compared with that of the control group (.13 Nm/kg) at terminal stance (p=.008). External knee flexion moment also increased in the transfemoral amputee group (.24 Nm/kg) but this difference was not statistically significant. External hip flexion moment increased in the transfemoral amputee group (1.35 Nm/kg) compared with that of the control group (.45 Nm/kg) at initial stance, and external hip extension moment decreased in the transfemoral amputee group (-.26 Nm/kg) compared with that of the control group (-.76 Nm/kg) at terminal stance. Although external ankle plantarflexion moment of the transfemoral amputee group increased, it was not found to be statistically significant. The results suggest that the intact limb joint moment of the uni-transfemoral amputees during walking can be different from that of healthy subjects. In conclusion, it was found that there is a link between the increase of external knee adduction moment and the prevalence of knee osteoarthritis in uni-transfemoral amputees. This result is expected to provide some objective data for rehabilitation programs related to knee osteoarthritis in transfemoral amputees.

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Comparisons of Kinematic Factors and Stiffnesses of the Lower-limb Joints between Transfemoral Amputees and Normal Adults (대퇴절단자와 정상인 걸음걸이의 운동학적 요인과 발목관절 강성 비교)

  • Yi, Jae-Hoon;Lee, Jung-Ho;Hah, Chong-Ku
    • Korean Journal of Applied Biomechanics
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    • v.23 no.1
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    • pp.77-83
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    • 2013
  • The purpose of this study was to compare kinematic variables and stiffnesses of ankle joints between normal person and transfemoral amputee gait in order to develop or fit prosthetic leg. Twenty subjects (ten normal persons and ten transfemoral amputees) participated in this experiment, and walked three trials at a self-selected pace. The gait motions were captured with Vicon system and variables were calculated with Visual-3D. The velocity, stride length, stride width, cycle time, double limb support time and right swing time of gaits were statistically significant. Because coefficients of variability of normal persons on velocity, double limb support time and swing time were greater than transfemoral amputees, normal persons controlled these gait variables effectively. The stiffnesses of ankle joints were not statistically significant, but patterns of stiffnesses of ankle joints during three rockers were absolutely different. The negative correlations between stiffnesses of ankle joints and cycle time and swing time were presented. These differences suggest that developing and fitting prosthetic leg were demanded. Further studies should develop fitting program and simulator of prosthetic leg.

A Musculoskeletal Model for Biomechanical Analysis of Transfemoral Amputees Climbing Stairs

  • Bae, Tae-Soo;Kim, Shin-Ki;Mun, Mu-Seong
    • International Journal of Precision Engineering and Manufacturing
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    • v.9 no.1
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    • pp.30-33
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    • 2008
  • Understanding the characteristics of amputee gait is key in developing more advanced prostheses. The aim of this study was to quantitatively analyze a stair-climbing task for transfemoral amputees with a prosthesis and to predict the muscle forces and joint moments at musculoskeletal joints using a dynamic analysis. A three-dimensional musculoskeletal model of the lower extremities was constructed from a gait analysis using transformation software for two transfemoral amputees and ten healthy people. The measured ground reaction forces and kinematical data of each joint from the gait analysis were used as input data for an inverse dynamic analysis. Dynamic analyses of an transfemoral amputee climbing stairs were performed using musculoskeletal models. The results showed that the summed muscle forces of the hip extensor of an amputated leg were greater than those of a sound leg. The opposite was true at the hip abductor and knee flexor of an amputated leg. We also found that higher moments at the hip and knee joints of the sound leg were required to overcome the flexion moment caused by the body weight and amputated leg. Dynamic analyses using musculoskeletal models may be a useful means to predict muscle forces and joint moments for specific motion tasks related to rehabilitation therapy.

Biomechanical Effect on Knee Adduction Moment by Lateral Wedge Insole in Transfemoral Amputee (외측웨지인솔이 대퇴절단자의 무릎내전모멘트에 미치는 영향)

  • Chang, Yun-Hee;Lee, Wan-Hee
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.2
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    • pp.239-244
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    • 2012
  • The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

Influence on amputee gait by the ankle joint alignment (발목관절 조절각도가 절단환자의 보행에 미치는 영향)

  • Kim, Y.H.;Yang, G.T.;Lim, S.H.;Chang, Y.H.;Mun, M.S.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.11
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    • pp.369-372
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    • 1997
  • Socket pressure distributions with gait analyses of a transfemoral and a transtibial prostheses were measured in order to assess an optimal socket fitting and unction. Ankle joint was aligned by the neutral and the dorsi/plantar flexed positions. Compared to dorsi and plantar flexed positions of ankle joint, cadence and walking speed increased with the neutral ankle joint alignment. Other gait parameters were close to the normative data with the neutral ankle joint alignment. For the transfemoral amputee, dorsiflexed alignment of the ankle joint created high pressure on the lateral aspect of the socket, on the other hand, plantarflexed alignment resulted in increased pressure on the medial aspect of the socket. For the transtibial amputee, dorsiflexed alignment of the ankle resulted in high pressure on the antero-lateral aspect of the socket during mid-stance, but plantarflexion of the ankle joint showed slight increases in pressure at the same location in the socket. The present study clearly demonstrated that malalignment of a prosthesis results in localized increasing pressure within the socket. Proper alignment of the prosthesis is required in order to acquire an appropriate socket-limb interface as well as the proper gait.

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Evaluation of Intralimb Coordination in Transfemoral Amputee during Level Walking (대퇴절단인의 보행 시 하지 내 협응성 평가)

  • Chang, Yoon-hee;Jeong, Bo-ra;Kang, Sung-jae;Ryu, Jei-cheong;Mun, Mu-seong;Ko, Chang-Yong
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.10 no.2
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    • pp.147-153
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    • 2016
  • The aims of this study were to evaluate the joint coordination between hip and knee joints in the transfemoral amputees, and its symmetry between sound and prosthetic limbs. Seven transfemoral amputees ($46.4{\pm}10.7-year-old$, $174.8{\pm}3.5cm$, $78.3{\pm}9.7kg$) and 7 able bodies ($24.0{\pm}4.5-year-old$, $174.5{\pm}5.9cm$, $66.9{\pm}9.4Kg$) participated in this study. They walked at a self-selected walking speed across a 10m level ground. Simultaneously angle and angular velocity in the hip and knee joint were measured by motion analysis system. Then continuos relative phase(CRP), standard deviations of CRP (CRP_SD) and symmetry index(SI) were calculated. In able bodies, there were no differences of the parameters between left and right limb(all p>0.05). However, significant differences between sound and prosthetic limb in most of the parameters, except for CRP for stance phase were shown (all p<0.05). There were differences in all SI between transfemoral amputees and able bodies (p<0.05). In conclusion, joint coordination was altered in transfemoral amputee during level walking and shown in interlimb asymmetry.

Relationships Between the Transfemoral Socket Interface Pressure and Myoelectric Signal of Residual Limb During Gait

  • Hong, J.H.;Lee, J.Y.;Chu, J.U.;Lee, J.Y.;Mun, M.S.
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2002.10a
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    • pp.1070-1073
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    • 2002
  • The biomechanical interaction between the stump and the prosthetic socket is critically important to achieve close-to-normal ambulation. Many investigators suggested that the pressure changes during gait of transfemoral amputees are closely related to the prosthetic alignment, the socket shape, the stump size, and the residual muscle activity. The effects of the prosthetic alignment, the socket shape, and the stump size on the interface pressure were investigated previously. However, there is no report how the residual muscle activities in the transfemoral stump affect the socket interface pressure characteristics during gait. Since designs of socket fur lower limb amputees need to consider the socket interface pressure characteristics, the interface pressure patterns by the residual muscle activities during gait should be investigated. In this study, myoelectric signals (MES) and socket interface pressure in residual limb of transfemoral amputees were measured during the stance and swing phases of gait. For the purpose, specially designed quadrilateral sockets that MES electrodes could be instrumented were fabricated. A total of two transfemoral amputees were participated in the experiments. The measured temporal MES amplitude and interface pressure in knee flexor (biceps femoris) and extensor (rectus femoris) had significant correlations (P < 0.05). Based on the test results, It was suggested that the residual muscle activity of transfemoral amputees stump is an important factor affecting socket pressure changes during walk.

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