Improved Weight-Bearing Symmetry for Transfemoral Amputees during Standing Up and Sitting Down with a Powered Knee-Ankle Prosthesis

Ann M. Simon, Nicholas P. Fey, Kimberly A. Ingraham, Suzanne B. Finucane, Elizabeth G. Halsne, Levi J. Hargrove

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: To test a new user-modulated control strategy that enables improved control of a powered knee-ankle prosthesis during sit-to-stand and stand-to-sit movements. Design: Within-subject comparison study. Setting: Gait laboratory. Participants: Unilateral transfemoral amputees (N=7; 4 men, 3 women) capable of community ambulation. Interventions: Subjects performed 10 repetitions of sit-to-stand and stand-to-sit with a powered knee-ankle prosthesis and with their prescribed passive prosthesis in a randomized order. With the powered prosthesis, knee and ankle power generation were controlled as a function of weight transferred onto the prosthesis. Main Outcome Measures: Vertical ground reaction force limb asymmetry and durations of movement were compared statistically (Wilcoxon signed-rank test, α=.05). Results: For sit-to-stand, peak vertical ground reaction forces were significantly less asymmetric using the powered prosthesis (mean, 19.3%±11.8%) than the prescribed prosthesis (57.9%±13.5%; P=.018), where positive asymmetry values represented greater force through the intact limb. For stand-to-sit, peak vertical ground reaction forces were also significantly less asymmetric using the powered prosthesis (28.06%±11.6%) than the prescribed prosthesis (48.2%±16%; P=.028). Duration of movement was not significantly different between devices (sit-to-stand: P=.18; stand-to-sit: P=.063). Conclusions: Allowing transfemoral amputees more control over the timing and rate of knee and ankle power generation enabled users to stand up and sit down with their weight distributed more equally between their lower limbs. Increased weight bearing on the prosthetic limb may make such activities of daily living easier for transfemoral amputees.

Original languageEnglish (US)
Pages (from-to)1100-1106
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume97
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Knee Prosthesis
Amputees
Weight-Bearing
Ankle
Prostheses and Implants
Extremities
Weights and Measures
Activities of Daily Living
Nonparametric Statistics
Gait
Walking
Lower Extremity
Knee
Outcome Assessment (Health Care)
Equipment and Supplies

Keywords

  • Artificial limbs
  • Lower extremity
  • Prosthesis design
  • Rehabilitation
  • Weight-bearing

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Improved Weight-Bearing Symmetry for Transfemoral Amputees during Standing Up and Sitting Down with a Powered Knee-Ankle Prosthesis. / Simon, Ann M.; Fey, Nicholas P.; Ingraham, Kimberly A.; Finucane, Suzanne B.; Halsne, Elizabeth G.; Hargrove, Levi J.

In: Archives of Physical Medicine and Rehabilitation, Vol. 97, No. 7, 01.07.2016, p. 1100-1106.

Research output: Contribution to journalArticle

Simon, Ann M. ; Fey, Nicholas P. ; Ingraham, Kimberly A. ; Finucane, Suzanne B. ; Halsne, Elizabeth G. ; Hargrove, Levi J. / Improved Weight-Bearing Symmetry for Transfemoral Amputees during Standing Up and Sitting Down with a Powered Knee-Ankle Prosthesis. In: Archives of Physical Medicine and Rehabilitation. 2016 ; Vol. 97, No. 7. pp. 1100-1106.
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abstract = "Objective: To test a new user-modulated control strategy that enables improved control of a powered knee-ankle prosthesis during sit-to-stand and stand-to-sit movements. Design: Within-subject comparison study. Setting: Gait laboratory. Participants: Unilateral transfemoral amputees (N=7; 4 men, 3 women) capable of community ambulation. Interventions: Subjects performed 10 repetitions of sit-to-stand and stand-to-sit with a powered knee-ankle prosthesis and with their prescribed passive prosthesis in a randomized order. With the powered prosthesis, knee and ankle power generation were controlled as a function of weight transferred onto the prosthesis. Main Outcome Measures: Vertical ground reaction force limb asymmetry and durations of movement were compared statistically (Wilcoxon signed-rank test, α=.05). Results: For sit-to-stand, peak vertical ground reaction forces were significantly less asymmetric using the powered prosthesis (mean, 19.3{\%}±11.8{\%}) than the prescribed prosthesis (57.9{\%}±13.5{\%}; P=.018), where positive asymmetry values represented greater force through the intact limb. For stand-to-sit, peak vertical ground reaction forces were also significantly less asymmetric using the powered prosthesis (28.06{\%}±11.6{\%}) than the prescribed prosthesis (48.2{\%}±16{\%}; P=.028). Duration of movement was not significantly different between devices (sit-to-stand: P=.18; stand-to-sit: P=.063). Conclusions: Allowing transfemoral amputees more control over the timing and rate of knee and ankle power generation enabled users to stand up and sit down with their weight distributed more equally between their lower limbs. Increased weight bearing on the prosthetic limb may make such activities of daily living easier for transfemoral amputees.",
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AU - Fey, Nicholas P.

AU - Ingraham, Kimberly A.

AU - Finucane, Suzanne B.

AU - Halsne, Elizabeth G.

AU - Hargrove, Levi J.

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N2 - Objective: To test a new user-modulated control strategy that enables improved control of a powered knee-ankle prosthesis during sit-to-stand and stand-to-sit movements. Design: Within-subject comparison study. Setting: Gait laboratory. Participants: Unilateral transfemoral amputees (N=7; 4 men, 3 women) capable of community ambulation. Interventions: Subjects performed 10 repetitions of sit-to-stand and stand-to-sit with a powered knee-ankle prosthesis and with their prescribed passive prosthesis in a randomized order. With the powered prosthesis, knee and ankle power generation were controlled as a function of weight transferred onto the prosthesis. Main Outcome Measures: Vertical ground reaction force limb asymmetry and durations of movement were compared statistically (Wilcoxon signed-rank test, α=.05). Results: For sit-to-stand, peak vertical ground reaction forces were significantly less asymmetric using the powered prosthesis (mean, 19.3%±11.8%) than the prescribed prosthesis (57.9%±13.5%; P=.018), where positive asymmetry values represented greater force through the intact limb. For stand-to-sit, peak vertical ground reaction forces were also significantly less asymmetric using the powered prosthesis (28.06%±11.6%) than the prescribed prosthesis (48.2%±16%; P=.028). Duration of movement was not significantly different between devices (sit-to-stand: P=.18; stand-to-sit: P=.063). Conclusions: Allowing transfemoral amputees more control over the timing and rate of knee and ankle power generation enabled users to stand up and sit down with their weight distributed more equally between their lower limbs. Increased weight bearing on the prosthetic limb may make such activities of daily living easier for transfemoral amputees.

AB - Objective: To test a new user-modulated control strategy that enables improved control of a powered knee-ankle prosthesis during sit-to-stand and stand-to-sit movements. Design: Within-subject comparison study. Setting: Gait laboratory. Participants: Unilateral transfemoral amputees (N=7; 4 men, 3 women) capable of community ambulation. Interventions: Subjects performed 10 repetitions of sit-to-stand and stand-to-sit with a powered knee-ankle prosthesis and with their prescribed passive prosthesis in a randomized order. With the powered prosthesis, knee and ankle power generation were controlled as a function of weight transferred onto the prosthesis. Main Outcome Measures: Vertical ground reaction force limb asymmetry and durations of movement were compared statistically (Wilcoxon signed-rank test, α=.05). Results: For sit-to-stand, peak vertical ground reaction forces were significantly less asymmetric using the powered prosthesis (mean, 19.3%±11.8%) than the prescribed prosthesis (57.9%±13.5%; P=.018), where positive asymmetry values represented greater force through the intact limb. For stand-to-sit, peak vertical ground reaction forces were also significantly less asymmetric using the powered prosthesis (28.06%±11.6%) than the prescribed prosthesis (48.2%±16%; P=.028). Duration of movement was not significantly different between devices (sit-to-stand: P=.18; stand-to-sit: P=.063). Conclusions: Allowing transfemoral amputees more control over the timing and rate of knee and ankle power generation enabled users to stand up and sit down with their weight distributed more equally between their lower limbs. Increased weight bearing on the prosthetic limb may make such activities of daily living easier for transfemoral amputees.

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KW - Weight-bearing

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