TPress

@article{Darter2023,

title = {Changes in frontal plane kinematics over 12-months in individuals with the Percutaneous Osseointegrated Prosthesis (POP)},

author = {B. J. Darter and E. D. Syrett and K. B. Foreman and E. Kubiak and S. Sinclair},

url = {https://www.embase.com/search/results?subaction=viewrecord&id=L2023020092&from=export},

doi = {10.1371/journal.pone.0281339},

issn = {1932-6203},

year  = {2023},

date = {2023-01-01},

journal = {PLoS ONE},

volume = {18},

number = {2 February},

address = {B.J. Darter, Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States},

abstract = {Background A bone-anchored prosthesis (BAP) eliminates the need for a conventional socket by attaching a prosthesis directly to the user's skeleton. Currently, limited research addresses changes in gait mechanics post BAP implantation. Objective Examine changes in frontal plane movement patterns after BAP implantation. Methods Participants were individuals with unilateral transfemoral amputation (TFA) enrolled in the US Food and Drug Administration (FDA) Early Feasibility Study examining the Percutaneous Osseointegrated Prosthesis (POP). The participants completed overground gait assessments using their conventional socket and at 6-weeks, 12-weeks, 6-months, and 12- months following POP implantation. Statistical parameter mapping techniques were used in examining changes in frontal plane kinematics over the 12-months and differences with reference values for individuals without limb loss. Results Statistically significant deviations were found pre-implantation compared to reference values for hip and trunk angles during prosthetic limb stance phase, and for pelvis and trunk relative to the pelvis angles during prosthetic limb swing. At 6-weeks post-implantation, only the trunk angle demonstrated a statistically significant reduction in the percent of gait cycle with deviations relative to reference values. At 12-months post-implantation, results revealed frontal plane movements were no longer statistically different across the gait cycle for the trunk angle compared to reference values, and less of the gait cycle was statistically different compared to reference values for all other frontal plane patterns analyzed. No statistically significant within-participant differences were found for frontal plane movement patterns between pre-implantation and 6-weeks or 12-months post-implantation. Conclusions Deviations from reference values displayed prior to device implantation were reduced or eliminated 12-months post-implantation in all frontal plane patterns analyzed, while withinparticipant changes over the 12-month period did not reach statistical significance. Overall, the results suggest the transition to a BAP aided in normalizing gait patterns in a sample of relatively high functioning individuals with TFA.},

keywords = {adult, amputation, article, Axtion, biomechanics, bone plate, cane, clinical article, frontal plane, gait, hip, hip adduction angle, hip angle, human, kinematics, limb prosthesis, male, middle aged, motion analysis system, Ossur Rheo, Ottobock C-Leg, Ottobock Genium, Ottobock X3, pelvic angle, pelvis lab angle, Pro-Flex Pivo, prosthesis implantation, radiographic parameter, Renegade XL, Rush Low Profile, Rush Renegade, software agent, torque, Triton, Triton Low Profile, trunk, trunk flexion angle, trunk lab angle, trunk pelvis angle, tyloxapol, unilateral transfemoral amputation, walker, walking speed, Wave Sport},

pubstate = {published},

tppubtype = {article}

}

@article{Williams2016,

title = {Impact on gait biomechanics of using an active variable impedance prosthetic knee},

author = {M. R. Williams and S. D'Andrea and H. M. Herr},

url = {https://www.embase.com/search/results?subaction=viewrecord&id=L610660431&from=export},

doi = {10.1186/s12984-016-0159-0},

issn = {1743-0003},

year  = {2016},

date = {2016-01-01},

journal = {J. NeuroEng. Rehabil.},

volume = {13},

number = {1},

address = {M.R. Williams, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States},

abstract = {Background: An above knee amputation can have a significant impact on gait, with substantial deviations in inter-leg symmetry, step length, hip exertion and upper body involvement even when using a current clinical standard of care prosthesis. These differences can produce gait that is less efficient and less comfortable, resulting in slower and shorter distance walking, particularly with long term use. Methods: A robotic variable impedance prosthetic knee (VI Knee) was tested with five individuals (N = 5) with unilateral amputation above the knee at fixed speeds both above and below their normal walking speed. Subject gait was measured as they walked along an instrumented walkway via optical motion capture and force plates in the floor. Each subject's gait while using the VI Knee was compared to that while using their standard of care knee (OttoBock C-Leg). Results: Significant differences (p < 0.05) in walking between the standard of care and variable impedance devices were seen in step length and hip range of motion symmetries, hip extension moment, knee power and torso lean angle. While using the VI Knee, several subjects demonstrated statistically significant improvements in gait, particularly in increased hip range of motion symmetry between affected and intact sides, greater prosthesis knee power and in reducing upper body involvement in the walking task by decreasing forward and affected side lean and reducing the pelvis-torso twist coupling. These changes to torso posture during gait also resulted in increased terminal stance hip flexion moment across subjects. Detriments to gait were also observed in that some subjects exhibited decreased step length symmetry while using the VI Knee compared to the C-Leg. Conclusions: The knee tested represents the potential to improve gait biomechanics and reduce upper body involvement in persons with above knee amputation compared to current standard of care devices. While using the VI Knee, subjects demonstrated statistically significant improvements in several aspects of gait though some were worsened while using the device. It is possible that these negative effects may be mitigated through longer term training and experience with the VI Knee. Given the demonstrated benefits and the potential to reduce or eliminate detriments through training, using a powered device like the VI Knee, particularly over an extended period of time, may help to improve walking performance and comfort.},

keywords = {above knee amputation, adult, aged, article, biomechanics, body position, C-leg, clinical article, College Park Trustep, controlled study, female, foot prosthesis, gait, gait biomechanics, hip, hip extension moment, human, knee power, knee prosthesis, Low Profile Vari-Flex, male, musculoskeletal system parameters, priority journal, range of motion, robotic variable impedance prosthetic knee, step length symmetry, torso lean angle, Triton, VI Knee, walking speed},

pubstate = {published},

tppubtype = {article}

}

@article{Darter2023,

title = {Changes in frontal plane kinematics over 12-months in individuals with the Percutaneous Osseointegrated Prosthesis (POP)},

author = {B. J. Darter and E. D. Syrett and K. B. Foreman and E. Kubiak and S. Sinclair},

url = {https://www.embase.com/search/results?subaction=viewrecord&id=L2023020092&from=export},

doi = {10.1371/journal.pone.0281339},

issn = {1932-6203},

year  = {2023},

date = {2023-01-01},

journal = {PLoS ONE},

volume = {18},

number = {2 February},

address = {B.J. Darter, Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, United States},

abstract = {Background A bone-anchored prosthesis (BAP) eliminates the need for a conventional socket by attaching a prosthesis directly to the user's skeleton. Currently, limited research addresses changes in gait mechanics post BAP implantation. Objective Examine changes in frontal plane movement patterns after BAP implantation. Methods Participants were individuals with unilateral transfemoral amputation (TFA) enrolled in the US Food and Drug Administration (FDA) Early Feasibility Study examining the Percutaneous Osseointegrated Prosthesis (POP). The participants completed overground gait assessments using their conventional socket and at 6-weeks, 12-weeks, 6-months, and 12- months following POP implantation. Statistical parameter mapping techniques were used in examining changes in frontal plane kinematics over the 12-months and differences with reference values for individuals without limb loss. Results Statistically significant deviations were found pre-implantation compared to reference values for hip and trunk angles during prosthetic limb stance phase, and for pelvis and trunk relative to the pelvis angles during prosthetic limb swing. At 6-weeks post-implantation, only the trunk angle demonstrated a statistically significant reduction in the percent of gait cycle with deviations relative to reference values. At 12-months post-implantation, results revealed frontal plane movements were no longer statistically different across the gait cycle for the trunk angle compared to reference values, and less of the gait cycle was statistically different compared to reference values for all other frontal plane patterns analyzed. No statistically significant within-participant differences were found for frontal plane movement patterns between pre-implantation and 6-weeks or 12-months post-implantation. Conclusions Deviations from reference values displayed prior to device implantation were reduced or eliminated 12-months post-implantation in all frontal plane patterns analyzed, while withinparticipant changes over the 12-month period did not reach statistical significance. Overall, the results suggest the transition to a BAP aided in normalizing gait patterns in a sample of relatively high functioning individuals with TFA.},

keywords = {adult, amputation, article, Axtion, biomechanics, bone plate, cane, clinical article, frontal plane, gait, hip, hip adduction angle, hip angle, human, kinematics, limb prosthesis, male, middle aged, motion analysis system, Ossur Rheo, Ottobock C-Leg, Ottobock Genium, Ottobock X3, pelvic angle, pelvis lab angle, Pro-Flex Pivo, prosthesis implantation, radiographic parameter, Renegade XL, Rush Low Profile, Rush Renegade, software agent, torque, Triton, Triton Low Profile, trunk, trunk flexion angle, trunk lab angle, trunk pelvis angle, tyloxapol, unilateral transfemoral amputation, walker, walking speed, Wave Sport},

pubstate = {published},

tppubtype = {article}

}

@article{Williams2016,

title = {Impact on gait biomechanics of using an active variable impedance prosthetic knee},

author = {M. R. Williams and S. D'Andrea and H. M. Herr},

url = {https://www.embase.com/search/results?subaction=viewrecord&id=L610660431&from=export},

doi = {10.1186/s12984-016-0159-0},

issn = {1743-0003},

year  = {2016},

date = {2016-01-01},

journal = {J. NeuroEng. Rehabil.},

volume = {13},

number = {1},

address = {M.R. Williams, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States},

abstract = {Background: An above knee amputation can have a significant impact on gait, with substantial deviations in inter-leg symmetry, step length, hip exertion and upper body involvement even when using a current clinical standard of care prosthesis. These differences can produce gait that is less efficient and less comfortable, resulting in slower and shorter distance walking, particularly with long term use. Methods: A robotic variable impedance prosthetic knee (VI Knee) was tested with five individuals (N = 5) with unilateral amputation above the knee at fixed speeds both above and below their normal walking speed. Subject gait was measured as they walked along an instrumented walkway via optical motion capture and force plates in the floor. Each subject's gait while using the VI Knee was compared to that while using their standard of care knee (OttoBock C-Leg). Results: Significant differences (p < 0.05) in walking between the standard of care and variable impedance devices were seen in step length and hip range of motion symmetries, hip extension moment, knee power and torso lean angle. While using the VI Knee, several subjects demonstrated statistically significant improvements in gait, particularly in increased hip range of motion symmetry between affected and intact sides, greater prosthesis knee power and in reducing upper body involvement in the walking task by decreasing forward and affected side lean and reducing the pelvis-torso twist coupling. These changes to torso posture during gait also resulted in increased terminal stance hip flexion moment across subjects. Detriments to gait were also observed in that some subjects exhibited decreased step length symmetry while using the VI Knee compared to the C-Leg. Conclusions: The knee tested represents the potential to improve gait biomechanics and reduce upper body involvement in persons with above knee amputation compared to current standard of care devices. While using the VI Knee, subjects demonstrated statistically significant improvements in several aspects of gait though some were worsened while using the device. It is possible that these negative effects may be mitigated through longer term training and experience with the VI Knee. Given the demonstrated benefits and the potential to reduce or eliminate detriments through training, using a powered device like the VI Knee, particularly over an extended period of time, may help to improve walking performance and comfort.},

keywords = {above knee amputation, adult, aged, article, biomechanics, body position, C-leg, clinical article, College Park Trustep, controlled study, female, foot prosthesis, gait, gait biomechanics, hip, hip extension moment, human, knee power, knee prosthesis, Low Profile Vari-Flex, male, musculoskeletal system parameters, priority journal, range of motion, robotic variable impedance prosthetic knee, step length symmetry, torso lean angle, Triton, VI Knee, walking speed},

pubstate = {published},

tppubtype = {article}

}