EFFECTS OF A PROSTHETIC FOOT WITH INCREASED CORONAL ADAPTABILITY ON CROSS-SLOPE WALKING
Notice bibliographique
Résumé
BACKGROUND: Walking on cross-slopes is a common but challenging task for persons with lower limb amputation. The uneven ground and the resulting functional leg length discrepancy in this situation requires adaptability of both user and prosthesis. OBJECTIVE(S): This study investigated the effects of a novel prosthetic foot that offers adaptability on cross-slope surfaces, using instrumented gait analysis and patient-reported outcomes. Moreover, the results were compared with two common prosthetic feet. METHODOLOGY: Twelve individuals with unilateral transtibial amputation and ten able-bodied control subjects participated in this randomized cross-over study. Participants walked on level ground and ±10° inclined cross-slopes at a self-selected walking speed. There were three prosthetic foot interventions: Triton Side Flex (TSF), Triton LP and Pro-Flex LP. The accommodation time for each foot was at least 4 weeks. The main outcome measures were as follows: frontal plane adaptation of shoe and prosthetic foot keel, mediolateral course of the center of pressure, ground reaction force in vertical and mediolateral direction, external knee adduction moment, gait speed, stance phase duration, step length and step width. Patient-reported outcomes assessed were the Activities Specific Balanced Confidence (ABC) scale, Prosthetic Limb Users Survey of Mobility (PLUS M) and Activities of Daily Living Questionnaire (ADL-Q). FINDINGS: The TSF prosthetic foot adapted both faster and to a greater extent to the cross-slope conditions compared to the Triton LP and Pro-Flex LP. The graphs for the mediolateral center of pressure course and mediolateral ground reaction force showed a distinct grouping for level ground and ±10° cross-slopes, similar to control subjects. In the ADL-Q, participants reported a higher level of perceived safety and comfort when using the TSF on cross-slopes. Eight out of twelve participants preferred the TSF over the reference. CONCLUSION: The frontal plane adaptation characteristics of the TSF prosthetic foot appear to be beneficial to the user and thus may enhance locomotion on uneven ground – specifically on cross-slopes. Layman's Abstract Walking on cross-slopes is a common but challenging task for persons with lower limb amputation. The adaptability of prostheses is limited. Users alter gait strategies to cope with uneven ground. The prosthetic foot is a central component of a lower limb prosthesis. This study investigated if a novel prosthetic foot with greater adaptability is beneficial on cross-slopes. Twelve individuals with transtibial amputation (ITTAs) took part in the study. In addition, ten abled-bodied persons were measured as controls. The ITTAs were fitted with the novel foot and a reference foot. The accommodation time for each foot was four weeks at least. Afterwards gait data and patient-reported outcomes were assessed. The analyzed gait data showed clear differences in terrain compliance for the measured feet. The novel foot adapts both faster and to a greater extent to the cross-slope conditions. The self-reported outcome measures revealed better comfort and perceived safety when using the adaptive foot concept in comparison to the commercial reference. These results suggest that the adaptation characteristics of the novel foot concept are beneficial to the user. Thus, it may enhance locomotion on uneven ground such as cross-slopes. Article PDF Link: How To Cite: Altenburg B, Ernst M, Maciejasz P, Schmalz T, Braatz F, Gerke H, Bellmann M. Effects of a prosthetic foot with increased coronal adaptability on cross-slope walking. Canadian Prosthetics & Orthotics Journal. 2021;Volume 4, Issue 1, No.7. https://doi.org/10.33137/cpoj.v4i1.35206 Corresponding Author: Björn Altenburg,Research Biomechanics, Ottobock SE & Co. KGaA, Göttingen, Germany.E-Mail: Bjoern.altenburg@ottobock.comORCID ID: https://orcid.org/0000-0002-3484-4346
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».