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Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off

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Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off. / Weinert-Aplin, RA; Howard, D; Twiste, M et al.
In: Medical engineering & physics, Vol. 39, 31.01.2017, p. 73-82.

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Weinert-Aplin RA, Howard D, Twiste M, Jarvis HL, Bennett AN, Baker RJ. Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off. Medical engineering & physics. 2017 Jan 31;39:73-82. Epub 2016 Dec 19. doi: 10.1016/j.medengphy.2016.10.005

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@article{c0cc39edbe474b7c80917a0731035866,
title = "Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off",
abstract = "Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking.Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments.At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12 W/kg vs. 1.05 W/kg for intact limbs and 0.97 W/kg vs. 0.99 W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12 W/kg vs. 0.87 W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip.This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.",
author = "RA Weinert-Aplin and D Howard and M Twiste and HL Jarvis and AN Bennett and RJ Baker",
year = "2017",
month = jan,
day = "31",
doi = "10.1016/j.medengphy.2016.10.005",
language = "English",
volume = "39",
pages = "73--82",
journal = "Medical engineering & physics",

}

RIS

TY - JOUR

T1 - Energy flow analysis of amputee walking shows a proximally-directed transfer of energy in intact limbs, compared to a distally-directed transfer in prosthetic limbs at push-off

AU - Weinert-Aplin, RA

AU - Howard, D

AU - Twiste, M

AU - Jarvis, HL

AU - Bennett, AN

AU - Baker, RJ

PY - 2017/1/31

Y1 - 2017/1/31

N2 - Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking.Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments.At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12 W/kg vs. 1.05 W/kg for intact limbs and 0.97 W/kg vs. 0.99 W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12 W/kg vs. 0.87 W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip.This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.

AB - Reduced capacity and increased metabolic cost of walking occurs in amputees, despite advances in prosthetic componentry. Joint powers can quantify deficiencies in prosthetic gait, but do not reveal how energy is exchanged between limb segments. This study aimed to quantify these energy exchanges during amputee walking.Optical motion and forceplate data collected during walking at a self-selected speed for cohorts of 10 controls, 10 unilateral trans-tibial, 10 unilateral trans-femoral and 10 bilateral trans-femoral amputees were used to determine the energy exchanges between lower limb segments.At push-off, consistent thigh and shank segment powers were observed between amputee groups (1.12 W/kg vs. 1.05 W/kg for intact limbs and 0.97 W/kg vs. 0.99 W/kg for prosthetic limbs), and reduced prosthetic ankle power, particularly in trans-femoral amputees (3.12 W/kg vs. 0.87 W/kg). Proximally-directed energy exchange was observed in the intact limbs of amputees and controls, while prosthetic limbs displayed distally-directed energy exchanges at the knee and hip.This study used energy flow analysis to show a reversal in the direction in which energy is exchanged between prosthetic limb segments at push-off. This reversal was required to provide sufficient energy to propel the limb segments and is likely a direct result of the lack of push-off power at the prosthetic ankle, particularly in trans-femoral amputees, and leads to their increased metabolic cost of walking.

UR - http://europepmc.org/abstract/med/27836575

U2 - 10.1016/j.medengphy.2016.10.005

DO - 10.1016/j.medengphy.2016.10.005

M3 - Journal article

C2 - 27836575

VL - 39

SP - 73

EP - 82

JO - Medical engineering & physics

JF - Medical engineering & physics

ER -