Abstract
Prosthetic suspension system is an important component of lower limb prostheses. Suspension efficiency can be best evaluated during one of the vital activities of daily living, i.e. walking. A new magnetic prosthetic suspension system has been developed, but its effects on gait biomechanics have not been studied. This study aimed to explore the effect of suspension type on kinetic and kinematic gait parameters during level walking with the new suspension system as well as two other commonly used systems (the Seal-In and pin/lock). Thirteen persons with transtibial amputation participated in this study. A Vicon motion system (six cameras, two force platforms) was utilized to obtain gait kinetic and kinematic variables, as well as pistoning within the prosthetic socket. The gait deviation index was also calculated based on the kinematic data. The findings indicated significant difference in the pistoning values among the three suspension systems. The Seal-In system resulted in the least pistoning compared with the other two systems. Several kinetic and kinematic variables were also affected by the suspension type. The ground reaction force data showed that lower load was applied to the limb joints with the magnetic suspension system compared with the pin/lock suspension. The gait deviation index showed significant deviation from the normal with all the systems, but the systems did not differ significantly. Main significant effects of the suspension type were seen in the GRF (vertical and fore-aft), knee and ankle angles. The new magnetic suspension system showed comparable effects in the remaining kinetic and kinematic gait parameters to the other studied systems. This study may have implications on the selection of suspension systems for transtibial prostheses.Trial RegistrationIranian Registry of Clinical Trials IRCT2013061813706N1.
Highlights
The primary goal of rehabilitation of lower limb amputees is to resume normal gait as much as possible
Amputees were eligible for the study if they were unilateral transtibial, could ambulate independently, had a stump free of ulcer and pain, had undergone amputation at least one year prior to the study, and had healthy upper limbs to don and doff the prosthesis without help
From the 15 participants, only the data for thirteen individuals were included in the statistical analysis
Summary
The primary goal of rehabilitation of lower limb amputees is to resume normal gait as much as possible. Gait asymmetry is one of the main concerns in unilateral lower limb amputees to avoid exertion of excessive load on the sound limb [1,2]. Previous research findings have been controversial over the kinetic and kinematic differences between the amputated and sound legs. Several studies indicated higher reliance on the sound leg by increased loading and stance time, which has been attributed to ankle loss in transtibial amputees [3,4]. Some literature supported the idea that amputees may not need to rely on the intact leg owing to the compensatory mechanisms adopted by the amputated leg [5]. A scientific justification is needed to encourage more symmetrical walking pattern
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