Abstract
ObjectivesThe objectives are to determine neural dynamics during gait using electro-encephalography and source localization, and to investigate the attentional demand during walking in able-bodied individuals, and individuals with an amputation.Materials & methodsSix able-bodied individuals conducted one experimental trial, and 6 unilateral transtibial and 6 unilateral transfemoral amputees performed 2 experimental trials; the first with the prosthesis currently used by the subjects and the second with a novel powered transtibial prosthesis, i.e. the Ankle Mimicking Prosthetic foot 4.0. Each experimental trial comprised 2 walking tasks; 6 and 2 minutes treadmill walking at normal speed interspersed by 5 minutes of rest. During 6 minutes walking the Sustained Attention to Response (go-no go) Task, which measures reaction time and accuracy, was performed. Electro-encephalographic data were gathered when subjects walked 2 minutes. Motor-related cortical potentials and brain source activity during gait were examined. Normality and (non-) parametric tests were conducted (p<0.05).Results and discussionIn contrast to transtibial amputees, transfemoral amputees required more attentional demands during walking with Ankle Mimicking Prosthetic foot 4.0 compared to the current passive prosthetic device and able-bodied individuals (reaction time and accuracy: p≤0.028). Since risk of falling is associated with altered attentional demands, propulsive forces of the novel device need to be better controlled for transfemoral amputees. No motor-related cortical potentials at Cz were observed in transfemoral amputees walking with the novel prosthesis, whereas motor-related cortical potentials between transtibial amputees and able-bodied individuals during walking at normal speed did not differ. The first positive electro-physiological peak deflection appeared during toe-off phase and showed higher activity within the underlying brain sources in transtibial amputees walking with Ankle Mimicking Prosthetic foot 4.0 compared to able-bodied individuals. The required higher neural input to accomplish the same physical activity compared to able-bodied individuals is possibly due to the limited acclimation period to the novel device and consequently increased afferent sensory feedback for postural control.
Highlights
Persons with an amputation strongly depend on prostheses to cope with daily activities
In contrast to transtibial amputees, transfemoral amputees required more attentional demands during walking with Ankle Mimicking Prosthetic foot 4.0 compared to the current passive prosthetic device and able-bodied individuals
The first positive electro-physiological peak deflection appeared during toe-off phase and showed higher activity within the underlying brain sources in transtibial amputees walking with Ankle Mimicking Prosthetic foot 4.0 compared to able-bodied individuals
Summary
Persons with an amputation strongly depend on prostheses to cope with daily activities. World-wide, engineers strive at improving prosthetics’ design and functionalities with the aim of optimising comfort and dexterity during daily activities. Most of these advances are still on a research level, their results show a preview of the upwards potential future prosthetics hold for amputees [1]. A previous paper of De Pauw et al [2] observed that the metabolic cost of AMPfoot 4.0 during walking is higher compared to the current prosthetic foot and able-bodied individuals Both transtibial and transfemoral amputees (TTA and TFA, respectively) recognize the added value of the locking-unlocking spring set mechanism used in its design. The latter might happen in TFA, since they do not lift the heel of the prosthetic device high enough to trigger the energy release of the spring set
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