Gait Analysis on Transtibial Subjects
Transtibial Prosthetics
Top to Bottom: CESR, Conventional, Prescribed
Transtibial amputation results in the loss of the ankle joint. This causes several range of motion limitations, and affects the symmetry of a patient's gait as well as the joint loading on the intact limb. Prosthetic technology has sought to create a more normalized artificial ankle joint, one that would mimic the range of motion of the intact ankle joint.
One study, conducted in 2011 by Morgenroth and colleagues, examined the mechanical loading on three prosthetic ankle designs used on transtibial patients. Their primary focus was on the external adduction moment (EAM) of the intact knee, which has been shown to increase the incidence of knee osteoarthritis, and the prosthetic foot-ankle push-off work (Morgenroth, Segal, Zelik, Czerneicki et al, 2011). They theorized that increased mechanical loading is a result of reduced push-off power and ground reaction force in the prosthetic limb. These kinematic factors affect gait symmetry, and cause excess loading on the intact limb. Morgenroth et al hypothesized that improved push-off in the prosthetic foot could reduce loading on the intact limb, and therefore reduce the peak knee external adduction moment during stance phase. Seven transtibial amputees were used in this study to identify the loading characteristics of three different prosthetic feet: the controlled energy storage and return (CESR), the conventional foot (Seattle LightFoot2), and a prescribed prosthetic foot.
They found that the CESR foot performed a significantly higher amount of push-off work than the other two prosthetic feet, and also resulted in a lower first peak EAM in the intact limb.
These results supported their hypothesis, and showed that the CESR was the most efficient at reducing the first peak EAM in the knee of the intact limb by increasing the load on the prosthetic limb.
The ankle joint is very important for a stable, symmetric gait. With controlled energy storage and return, a prosthetic ankle joint on a transtibial patient can reduce asymmetric joint loading on the intact limb and subsequently reduce incidence of knee osteoarthritis in the intact limb.
Graphical representations of the results of this study are shown below:
One study, conducted in 2011 by Morgenroth and colleagues, examined the mechanical loading on three prosthetic ankle designs used on transtibial patients. Their primary focus was on the external adduction moment (EAM) of the intact knee, which has been shown to increase the incidence of knee osteoarthritis, and the prosthetic foot-ankle push-off work (Morgenroth, Segal, Zelik, Czerneicki et al, 2011). They theorized that increased mechanical loading is a result of reduced push-off power and ground reaction force in the prosthetic limb. These kinematic factors affect gait symmetry, and cause excess loading on the intact limb. Morgenroth et al hypothesized that improved push-off in the prosthetic foot could reduce loading on the intact limb, and therefore reduce the peak knee external adduction moment during stance phase. Seven transtibial amputees were used in this study to identify the loading characteristics of three different prosthetic feet: the controlled energy storage and return (CESR), the conventional foot (Seattle LightFoot2), and a prescribed prosthetic foot.
They found that the CESR foot performed a significantly higher amount of push-off work than the other two prosthetic feet, and also resulted in a lower first peak EAM in the intact limb.
These results supported their hypothesis, and showed that the CESR was the most efficient at reducing the first peak EAM in the knee of the intact limb by increasing the load on the prosthetic limb.
The ankle joint is very important for a stable, symmetric gait. With controlled energy storage and return, a prosthetic ankle joint on a transtibial patient can reduce asymmetric joint loading on the intact limb and subsequently reduce incidence of knee osteoarthritis in the intact limb.
Graphical representations of the results of this study are shown below:
Extra Reading:
For more information regarding transtibial gait and joint loading, check out the links below.