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A combined kinematic and kinetic analysis at the residuum/socket interface of a knee-disarticulation amputee

A combined kinematic and kinetic analysis at the residuum/socket interface of a knee-disarticulation amputee
A combined kinematic and kinetic analysis at the residuum/socket interface of a knee-disarticulation amputee
Background
The bespoke interface between a lower limb residuum and a prosthetic socket is critical for an amputee’s comfort and overall rehabilitation outcomes. Analysis of interface kinematics and kinetics is important to gain full understanding of the interface biomechanics, which could aid clinical socket fit, rehabilitation and amputee care. This pilot study aims to investigate the dynamic correlation between kinematic movement and kinetic stresses at the interface during walking tests on different terrains.
Methods
One male, knee disarticulation amputee participated in the study. He was asked to walk on both a level surface and a 5° ramped surface. The movement between the residuum and the socket was evaluated by the angular and axial couplings, based on the outputs from a 3D motion capture system. The corresponding kinetic stresses at anterior-proximal (AP), posterior-proximal (PP) and anterior-distal (AD) locations of the residuum were measured, using individual stress sensors.
Findings
Approximately 8° of angular coupling and up to 32mm of axial coupling were measured when walking on different terrains. The direction of the angular coupling shows strong correlation with the pressure difference between the PP and AP sensors. Higher pressure was obtained at the PP location than the AP location during stance phase, associated with the direction of the angular coupling. A strong correlation between axial coupling length, L, and longitudinal shear was also evident at the PP and AD locations i.e. the shortening of L corresponds to the increase of shear in the proximal direction. Although different terrains did not affect these correlations in principle, interface kinematic and kinetic values suggested that gait changes can induce modifications to the interface biomechanics.
Clinical relevance
It is envisaged that the reported techniques could be potentially used to provide combined kinematics and kinetics for the understanding of biomechanics at the residuum/socket interface, which may play an important role in the clinical assessment of prosthetic component settings, including socket fit quality.
1350-4533
Tang, Jinghua
b4b9a22c-fd6d-427a-9ab1-51184c1d2a2c
Mcgrath, Michael
32b5ce9d-eada-4edb-9c2e-ebc4d05142e9
Hale, Nicholas
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Jiang, Liudi
374f2414-51f0-418f-a316-e7db0d6dc4d1
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Laszczak, Piotr
83f0c73b-a2d3-4bc6-967f-579497af0754
Moser, David
09874cab-348f-47f9-b018-1c2875d16998
Zahedi, Saeed
fec0d8af-5088-4b23-b94e-2ba1d019850a
Tang, Jinghua
b4b9a22c-fd6d-427a-9ab1-51184c1d2a2c
Mcgrath, Michael
32b5ce9d-eada-4edb-9c2e-ebc4d05142e9
Hale, Nicholas
3efb2814-5536-480d-897e-f15985accdee
Jiang, Liudi
374f2414-51f0-418f-a316-e7db0d6dc4d1
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Laszczak, Piotr
83f0c73b-a2d3-4bc6-967f-579497af0754
Moser, David
09874cab-348f-47f9-b018-1c2875d16998
Zahedi, Saeed
fec0d8af-5088-4b23-b94e-2ba1d019850a

Tang, Jinghua, Mcgrath, Michael, Hale, Nicholas, Jiang, Liudi, Bader, Daniel, Laszczak, Piotr, Moser, David and Zahedi, Saeed (2017) A combined kinematic and kinetic analysis at the residuum/socket interface of a knee-disarticulation amputee. Medical Engineering & Physics. (doi:10.1016/j.medengphy.2017.08.014).

Record type: Article

Abstract

Background
The bespoke interface between a lower limb residuum and a prosthetic socket is critical for an amputee’s comfort and overall rehabilitation outcomes. Analysis of interface kinematics and kinetics is important to gain full understanding of the interface biomechanics, which could aid clinical socket fit, rehabilitation and amputee care. This pilot study aims to investigate the dynamic correlation between kinematic movement and kinetic stresses at the interface during walking tests on different terrains.
Methods
One male, knee disarticulation amputee participated in the study. He was asked to walk on both a level surface and a 5° ramped surface. The movement between the residuum and the socket was evaluated by the angular and axial couplings, based on the outputs from a 3D motion capture system. The corresponding kinetic stresses at anterior-proximal (AP), posterior-proximal (PP) and anterior-distal (AD) locations of the residuum were measured, using individual stress sensors.
Findings
Approximately 8° of angular coupling and up to 32mm of axial coupling were measured when walking on different terrains. The direction of the angular coupling shows strong correlation with the pressure difference between the PP and AP sensors. Higher pressure was obtained at the PP location than the AP location during stance phase, associated with the direction of the angular coupling. A strong correlation between axial coupling length, L, and longitudinal shear was also evident at the PP and AD locations i.e. the shortening of L corresponds to the increase of shear in the proximal direction. Although different terrains did not affect these correlations in principle, interface kinematic and kinetic values suggested that gait changes can induce modifications to the interface biomechanics.
Clinical relevance
It is envisaged that the reported techniques could be potentially used to provide combined kinematics and kinetics for the understanding of biomechanics at the residuum/socket interface, which may play an important role in the clinical assessment of prosthetic component settings, including socket fit quality.

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More information

Submitted date: 7 August 2017
Accepted/In Press date: 21 August 2017
e-pub ahead of print date: 15 September 2017

Identifiers

Local EPrints ID: 414185
URI: http://eprints.soton.ac.uk/id/eprint/414185
ISSN: 1350-4533
PURE UUID: e9dc139d-3759-4f4f-9d62-a888cee81032
ORCID for Jinghua Tang: ORCID iD orcid.org/0000-0003-3359-5891
ORCID for Liudi Jiang: ORCID iD orcid.org/0000-0002-3400-825X
ORCID for Daniel Bader: ORCID iD orcid.org/0000-0002-1208-3507

Catalogue record

Date deposited: 18 Sep 2017 16:31
Last modified: 17 Dec 2019 05:54

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Contributors

Author: Jinghua Tang ORCID iD
Author: Michael Mcgrath
Author: Nicholas Hale
Author: Liudi Jiang ORCID iD
Author: Daniel Bader ORCID iD
Author: Piotr Laszczak
Author: David Moser
Author: Saeed Zahedi

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