Stride-to-stride fluctuations in transtibial amputees are not affected by changes in push-off mechanics from using different prostheses

Chase G. Rock, Shane R. Wurdeman, Nicholas Stergiou, Kota Z. Takahashi

Research output: Contribution to journalArticle

Abstract

Stride-to-stride fluctuations of joint kinematics during walking reflect a highly structured organization that is characteristic of healthy gait. The organization of stride-to-stride fluctuations is disturbed in lower-limb prosthesis users, yet the factors contributing to this difference are unclear. One potential contributor to the changes in stride-to-stride fluctuations is the altered push-off mechanics experienced by passive prosthesis users. The purpose of our study was to determine if changes in push-off mechanics affect stride-to-stride fluctuations in transtibial amputees. Twenty-two unilateral transtibial amputees were enrolled in the 6- week cross-over study, where High and Low Activity (based on the Medicare Functional Classification System) prostheses were worn for three weeks each. Data collection took place at the end of the third week. Participants walked on a treadmill in a motion capture laboratory to quantify stride-to-stride fluctuations of the lower extremity joint angle trajectories using the largest Lyapunov Exponent, and over floor-embedded force platforms to enable calculating push-off work from the prosthesis and the sound limb. Push-off work was 140% greater in the High Activity prosthesis compared to the Low Activity prosthesis (p < 0.001), however no significant change was observed in stride-to-stride fluctuations of the ankle between the two prosthesis types (p = 0.576). There was no significant correlation between changes in prosthesis push-off work and the largest Lyapunov exponent. Though differences in push-off work were observed between the two prosthesis types, stride-to-stride fluctuations remained similar, indicating that prosthesis propulsion mechanics may not be a strong determinant of stride-to-stride fluctuations in unpowered transtibial prosthesis users.

Original languageEnglish (US)
Article numbere0205098
JournalPloS one
Volume13
Issue number10
DOIs
StatePublished - Oct 2018

Fingerprint

Amputees
prostheses
Prosthetics
Mechanics
mechanics
Prostheses and Implants
limbs (animal)
Lower Extremity
Joints
Artificial Limbs
Organizations
Exercise equipment
Medicare
exercise equipment
Gait
Biomechanical Phenomena
Ankle
gait
Cross-Over Studies
Propulsion

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Stride-to-stride fluctuations in transtibial amputees are not affected by changes in push-off mechanics from using different prostheses. / Rock, Chase G.; Wurdeman, Shane R.; Stergiou, Nicholas; Takahashi, Kota Z.

In: PloS one, Vol. 13, No. 10, e0205098, 10.2018.

Research output: Contribution to journalArticle

@article{ebb31a4f65634f479f2c4be9752dad14,
title = "Stride-to-stride fluctuations in transtibial amputees are not affected by changes in push-off mechanics from using different prostheses",
abstract = "Stride-to-stride fluctuations of joint kinematics during walking reflect a highly structured organization that is characteristic of healthy gait. The organization of stride-to-stride fluctuations is disturbed in lower-limb prosthesis users, yet the factors contributing to this difference are unclear. One potential contributor to the changes in stride-to-stride fluctuations is the altered push-off mechanics experienced by passive prosthesis users. The purpose of our study was to determine if changes in push-off mechanics affect stride-to-stride fluctuations in transtibial amputees. Twenty-two unilateral transtibial amputees were enrolled in the 6- week cross-over study, where High and Low Activity (based on the Medicare Functional Classification System) prostheses were worn for three weeks each. Data collection took place at the end of the third week. Participants walked on a treadmill in a motion capture laboratory to quantify stride-to-stride fluctuations of the lower extremity joint angle trajectories using the largest Lyapunov Exponent, and over floor-embedded force platforms to enable calculating push-off work from the prosthesis and the sound limb. Push-off work was 140{\%} greater in the High Activity prosthesis compared to the Low Activity prosthesis (p < 0.001), however no significant change was observed in stride-to-stride fluctuations of the ankle between the two prosthesis types (p = 0.576). There was no significant correlation between changes in prosthesis push-off work and the largest Lyapunov exponent. Though differences in push-off work were observed between the two prosthesis types, stride-to-stride fluctuations remained similar, indicating that prosthesis propulsion mechanics may not be a strong determinant of stride-to-stride fluctuations in unpowered transtibial prosthesis users.",
author = "Rock, {Chase G.} and Wurdeman, {Shane R.} and Nicholas Stergiou and Takahashi, {Kota Z.}",
year = "2018",
month = "10",
doi = "10.1371/journal.pone.0205098",
language = "English (US)",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "10",

}

TY - JOUR

T1 - Stride-to-stride fluctuations in transtibial amputees are not affected by changes in push-off mechanics from using different prostheses

AU - Rock, Chase G.

AU - Wurdeman, Shane R.

AU - Stergiou, Nicholas

AU - Takahashi, Kota Z.

PY - 2018/10

Y1 - 2018/10

N2 - Stride-to-stride fluctuations of joint kinematics during walking reflect a highly structured organization that is characteristic of healthy gait. The organization of stride-to-stride fluctuations is disturbed in lower-limb prosthesis users, yet the factors contributing to this difference are unclear. One potential contributor to the changes in stride-to-stride fluctuations is the altered push-off mechanics experienced by passive prosthesis users. The purpose of our study was to determine if changes in push-off mechanics affect stride-to-stride fluctuations in transtibial amputees. Twenty-two unilateral transtibial amputees were enrolled in the 6- week cross-over study, where High and Low Activity (based on the Medicare Functional Classification System) prostheses were worn for three weeks each. Data collection took place at the end of the third week. Participants walked on a treadmill in a motion capture laboratory to quantify stride-to-stride fluctuations of the lower extremity joint angle trajectories using the largest Lyapunov Exponent, and over floor-embedded force platforms to enable calculating push-off work from the prosthesis and the sound limb. Push-off work was 140% greater in the High Activity prosthesis compared to the Low Activity prosthesis (p < 0.001), however no significant change was observed in stride-to-stride fluctuations of the ankle between the two prosthesis types (p = 0.576). There was no significant correlation between changes in prosthesis push-off work and the largest Lyapunov exponent. Though differences in push-off work were observed between the two prosthesis types, stride-to-stride fluctuations remained similar, indicating that prosthesis propulsion mechanics may not be a strong determinant of stride-to-stride fluctuations in unpowered transtibial prosthesis users.

AB - Stride-to-stride fluctuations of joint kinematics during walking reflect a highly structured organization that is characteristic of healthy gait. The organization of stride-to-stride fluctuations is disturbed in lower-limb prosthesis users, yet the factors contributing to this difference are unclear. One potential contributor to the changes in stride-to-stride fluctuations is the altered push-off mechanics experienced by passive prosthesis users. The purpose of our study was to determine if changes in push-off mechanics affect stride-to-stride fluctuations in transtibial amputees. Twenty-two unilateral transtibial amputees were enrolled in the 6- week cross-over study, where High and Low Activity (based on the Medicare Functional Classification System) prostheses were worn for three weeks each. Data collection took place at the end of the third week. Participants walked on a treadmill in a motion capture laboratory to quantify stride-to-stride fluctuations of the lower extremity joint angle trajectories using the largest Lyapunov Exponent, and over floor-embedded force platforms to enable calculating push-off work from the prosthesis and the sound limb. Push-off work was 140% greater in the High Activity prosthesis compared to the Low Activity prosthesis (p < 0.001), however no significant change was observed in stride-to-stride fluctuations of the ankle between the two prosthesis types (p = 0.576). There was no significant correlation between changes in prosthesis push-off work and the largest Lyapunov exponent. Though differences in push-off work were observed between the two prosthesis types, stride-to-stride fluctuations remained similar, indicating that prosthesis propulsion mechanics may not be a strong determinant of stride-to-stride fluctuations in unpowered transtibial prosthesis users.

UR - http://www.scopus.com/inward/record.url?scp=85054442596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85054442596&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0205098

DO - 10.1371/journal.pone.0205098

M3 - Article

C2 - 30281652

AN - SCOPUS:85054442596

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 10

M1 - e0205098

ER -