Acta Gymnica, 2017 (vol. 47), issue 3

Acta Gymnica 2017, 47(3):130-137 | 10.5507/ag.2017.016

Kinematics of gait using bionic and hydraulic knee joints in transfemoral amputees

Jaroslav Uchytil1, Daniel Jandačka1, Roman Farana1, David Zahradník1, Jiri Rosicky2, Miroslav Janura3
1 Faculty of Education, University of Ostrava, Ostrava, Czech Republic;
2 ING Corporation, spol. s r. o., Frýdek-Místek, Czech Republic;
3 Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic

Background: The development of new technologies has led to further improvements in prosthetic knee joints.

Objective: The aim of this study was to compare angle parameters in knee and hip joints during the gait of transfemoral amputees and to determine the effect of the type of knee joint used on their symmetry. The study also compared pelvic movements in transfemoral amputees using different types of knee joints.

Method: Eleven patients (5 female, 6 male, mean age 39.2 ± 10.1 years, height 171.8 ± 9.5 cm, mass 71.5 ± 11.0 kg) with a transfemoral amputation (5 used bionic knee, 6 used hydraulic knee) participated in this study. The control group consisted of 10 individuals with no locomotion-related problems (2 female, 8 male).

Results: Movement was more symmetrical in the hip joint for all monitored parameters in patients with bionic knee joints. Flexion at heel contact and maximum flexion in the swing phase in the knee joint were more symmetrical in the group with hydraulic knee joints; for all other parameters the group with bionic knee joints achieved better symmetry. The kinematics of pelvic movement in the patients using hydraulic knee joints differed from the control group in all monitored parameters. The greatest difference with excellent effect size (ES = 7.96) was found in pelvic tilt. Pelvic tilt was higher when using hydraulic knee joints.

Conclusion:  In comparison with the mechanically passive knee joint, gait with the bionic knee joint evinced gait symmetry.

Keywords: amputation, prosthesis, bionic knee joint, kinematic analysis

Received: February 23, 2017; Accepted: August 29, 2017; Prepublished online: September 25, 2017; Published: October 6, 2017

Download citation

References

  1. Bartlett, R., Wheat, J., & Robins, M. (2007). Is movement variability important for sports biomechanists? Sports Biomechanics, 6, 224-243. Go to original source... Go to PubMed...
  2. Bellmann, M., Schmalz, T., & Blumentritt, S. (2010). Comparative biomechanical analysis of current microprocessor-controlled prosthetic knee joints. Archives of Physical Medicine and Rehabilitation, 91, 644-652. Go to original source... Go to PubMed...
  3. Benedetti, M. G., Catani, F., Leardini, A., Pignotti, E., & Giannini, S. (1998). Data management in gait analysis for clinical applications. Clinical Biomechanics, 13, 204-215. Go to original source... Go to PubMed...
  4. Cappozzo, A., Figura, F., Gazzani, F., Leo, T., & Marchetti, M. (1982). Angular displacement in the upper body of AK amputees during level walking. Prosthetics and Orthotics International, 6, 131-138. Go to PubMed...
  5. Dingwell, J. B., Davis, B. L., & Frazier, D. M. (1996). Use of an instrumented treadmill for real-time gait symmetry evaluation and feedback in normal and trans-tibial amputee subjects. Prosthetics and Orthotics International, 20, 101-110. Go to PubMed...
  6. Dormandy, J., Heeck, L., & Vig, S. (1999). Major amputations: Clinical patterns and predictors. Seminars in Vascular Surgery, 12, 154-161. Go to PubMed...
  7. Gailey, R., Allen, K., Castles, J., Kucharik, J., & Roeder, M. (2008). Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. Journal of Rehabilitation Research and Development, 45, 15-29. Go to original source... Go to PubMed...
  8. Goujon-Pillet, H., Sapin, E., Fodé, P., & Lavaste, F. (2008). Three-dimensional motions of trunk and pelvis during transfemoral amputee gait. Archives of Physical Medicine and Rehabilitation, 89, 87-94. Go to original source... Go to PubMed...
  9. Hemakumar, D., Tumilty, S., & Smith, C. (2012). Physical activity and lower-back pain in person with traumatic transfemoral amputation: A national cross-sectional survey. Journal of Rehabilitation Research & Development, 49, 1457-1466.
  10. Hopkins, W. G. (2000). Measures of reliability in sports medicine and science. Sports Medicine, 30, 1-15. Go to original source... Go to PubMed...
  11. Hopkins, W. G. (2014). A new view of statistics. Retrieved from http://sportsci.org/resource/stats/effectmag.html
  12. Johansson, J. L., Sherrill, D. M., Riley, P. O., Bonato, P., & Herr, H. (2005). A clinical comparison of variable-damping and mechanically passive prosthetic knee devices. American Journal of Physical Medicine & Rehabilitation, 84, 563-575. Go to original source...
  13. Kaufman, K. R., Frittoli, S., & Frigo, C. A. (2012). Gait asymmetry of transfemoral amputees using mechanical and microprocessor-controled prosthetic knees. Clinical Biomechanics, 27, 460-465. Go to original source... Go to PubMed...
  14. Kishner, S. (2013). Gait analysis after amputation. Retrieved from http://emedicine.medscape.com/article/1237638-overview#a1
  15. Mâaref, K., Martinet, N., Grumillier, C., Ghannouchi, S., André, J. M., & Paysant, J. (2010). Kinematics in the terminal swing phase of unilateral transfemoral amputees: Microprocessor-controlled versus swing-phase control prosthetic knees. Archives of Physical Medicine and Rehabilitation, 91, 919-925. Go to original source... Go to PubMed...
  16. Morgenroth, D. C., Shakir, A., Orendurff, M. S., & Czerniecki, J. M. (2009). Low-back pain in transfemoral amputees: Is there a correlation with static or dynamic leg-length discrepancy? American Journal of Physical Medicine & Rehabilitation, 88, 108-113. Go to original source...
  17. Nolan, L., Wit, A., Dudziñski, K., Lees, A., Lake, M., & Wychowañski, M. (2003). Adjustments in gait symmetry with walking speed in trans-femoral and trans-tibial amputees. Gait and Posture, 17, 142-151. Go to original source... Go to PubMed...
  18. Petersen, A. O., Comins, J., & Alkjær, T. (2010). Assessment of gait symmetry in transfemoral amputees using C-Leg compared with 3R60 prosthetic knees. Journal of Prosthetics and Orthotics, 22, 106-113. Go to original source...
  19. Sagawa, Y., Turcot, K., Armand, S., Thevenon, A., Vuillerme, N., & Watelain, E. (2011). Biomechanics and physiological parameters during gait in lower-limb amputees: A systematic review. Gait and Posture, 33, 511-526. Go to original source... Go to PubMed...
  20. Schaarschmidt, M., Lipfert, S. W., Meier-Gratz, C., Scholle, H.-C., & Seyfarth, A. (2012). Functional gait asymmetry of unilateral transfemoral amputees. Human Movement Science, 31, 907-917. Go to original source... Go to PubMed...
  21. Segal, D. A., Orendurff, M. S., Klute, G. K., McDowell, M. L., Pecoraro, J. A., Shofer, J., & Czerniecki, J. M. (2006). Kinematic and kinetic comparison of transfemoral amputee gait using C-Leg and Mauch SNS prosthetic knees. Journal of Rehabilitation Research & Development, 43, 857-870. Go to original source...
  22. Silver-Thorn, B. M., & Glaister, C. L. (2009). Functional stability of transfemoral amputee gait using the 3R80 and Total Knee 2000 prosthetic knee units. Journal of Prosthetics and Orthotics, 21, 18-31. Go to original source...
  23. Stoquart, G., Detrembleur, C., & Lejeune, T. (2008). Effect of speed on kinematic, kinetic, electromyographic and energetic reference values during treadmill walking. Clinical Neurophysiology, 38, 105-116. Go to original source... Go to PubMed...
  24. Uchytil, J., Jandacka, D., Zahradnik, D., Farana, R., & Janura, M. (2014). Temporal-spatial parameters of gait in transfemoral amputees: Comparison of bionic and mechanically passive knee joints. Prosthetics and Orthotics International, 38, 199-204. Go to original source... Go to PubMed...