Amputee Locomotion: Joint Moment Adaptations to Running Speed using Running-Specific Prostheses after Unilateral Transtibial Amputation

AbstractObjectiveThe objective of this study was to investigate 3D lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses.Design8 individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/s). A 2x2x3 (group x leg x speed) repeated-measures ANOVA with Bonferroni adjustments determined statistical significance.ResultsThe prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb. The intact limb had greater peak hip external rotation moments than control limbs, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than the prosthetic limb.ConclusionIndividuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs. Objective The objective of this study was to investigate 3D lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses. Design 8 individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/s). A 2x2x3 (group x leg x speed) repeated-measures ANOVA with Bonferroni adjustments determined statistical significance. Results The prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb. The intact limb had greater peak hip external rotation moments than control limbs, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than the prosthetic limb. Conclusion Individuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs. Corresponding Author: Jae Kun Shim, PhD, Department of Kinesiology, University of Maryland, College Park, 0110F School of Public Health (Bldg #225), 2242 Valley Drive, College Park, MD 20742, E-mail address: jkshim@umd.edu Disclosures: The authors have no conflicts of interest. This work was funded by the National Institute of Arthritis and Musculoskeletal and Skin Disease (NIAMS) R03 Award #1R03AR062321 and the University of Maryland Department of Kinesiology Graduate Research Initiative Fund. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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