Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee
Abstract Background Above-knee amputations (AKAs) contribute to gait asymmetry. The level of asymmetry is affected by the type of knee prosthetic module. There is limited evidence suggesting that more technically advanced solutions (microprocessor modules; MicPK) are superior to less advanced ones (...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s12984-021-00810-w |
| _version_ | 1818720157906763776 |
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| author | Mateusz Kowal Sławomir Winiarski Ewa Gieysztor Anna Kołcz Karolina Walewicz Wojciech Borowicz Alicja Rutkowska-Kucharska Małgorzata Paprocka-Borowicz |
| author_facet | Mateusz Kowal Sławomir Winiarski Ewa Gieysztor Anna Kołcz Karolina Walewicz Wojciech Borowicz Alicja Rutkowska-Kucharska Małgorzata Paprocka-Borowicz |
| author_sort | Mateusz Kowal |
| collection | DOAJ |
| description | Abstract Background Above-knee amputations (AKAs) contribute to gait asymmetry. The level of asymmetry is affected by the type of knee prosthetic module. There is limited evidence suggesting that more technically advanced solutions (microprocessor modules; MicPK) are superior to less advanced ones (mechanical modules; MechPK). The study aimed to evaluate the variable range of hip and pelvic joint movements during gait and look for differentiating areas with an increased level of asymmetry of the gait cycle in individuals who underwent an AKA and are equipped with MicPK or MechPK. Methods Twenty-eight individuals participated in the study; 14 were assigned to a study group of individuals who underwent a unilateral AKA, and the other 14 were healthy participants as a control group. The movement task was recorded using the optoelectronic SMART-E system following the standard Davis protocol (the Newington model). A new method of quantifying gait symmetry using the symmetry function (SF) is proposed. SF is an integral measure of absolute differences in time-standardized signals between sides throughout the whole cycle of motion variability. Results In the frontal plane, there were significant differences between groups in the asymmetry of the range of movement in the hip joint of the intact limb. In the middle of the support phase, the intact limb was more adducted in individuals with MicPK and less abducted in people with MechPK (differences in mean 180%, p < 0.000; max 63%, p < 0.000; min 65%, p < 0.000). In the sagittal plane, the range of asymmetry of the flexion and thigh extension of the intact limb was similar to and only slightly different from the physiological gait. In the transverse plane, higher asymmetry values were noted for individuals with MicPK. In the final stage of the swing phase, the thigh was more rotated both externally and internally. The size of the asymmetry, when compared to gait of healthy individuals, reached 50% (differences in mean 115%, p < 0.232; max 62% p < 0.26; min 50, p < 0.154). Conclusions In the study group, the assessed ranges of pelvic and thigh movement in the hip joint differed only in the frontal plane. Individuals who underwent a unilateral above-knee amputation may gain less from using MicPK than anticipated. |
| first_indexed | 2024-12-17T20:18:23Z |
| format | Article |
| id | doaj.art-f7d9bf136fae410698d4bba8127e821a |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-17T20:18:23Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-f7d9bf136fae410698d4bba8127e821a2022-12-21T21:34:01ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032021-01-0118111210.1186/s12984-021-00810-wSymmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic kneeMateusz Kowal0Sławomir Winiarski1Ewa Gieysztor2Anna Kołcz3Karolina Walewicz4Wojciech Borowicz5Alicja Rutkowska-Kucharska6Małgorzata Paprocka-Borowicz7Department of Physiotherapy, Wroclaw Medical UniversityDepartment of Biomechanics, University School of Physical Education in WroclawDepartment of Physiotherapy, Wroclaw Medical UniversityDepartment of Physiotherapy, Wroclaw Medical UniversityFaculty of Health Sciences, University of OpoleDepartment of Nervous System Diseases, Wroclaw Medical UniversityDepartment of Biomechanics, University School of Physical Education in WroclawDepartment of Physiotherapy, Wroclaw Medical UniversityAbstract Background Above-knee amputations (AKAs) contribute to gait asymmetry. The level of asymmetry is affected by the type of knee prosthetic module. There is limited evidence suggesting that more technically advanced solutions (microprocessor modules; MicPK) are superior to less advanced ones (mechanical modules; MechPK). The study aimed to evaluate the variable range of hip and pelvic joint movements during gait and look for differentiating areas with an increased level of asymmetry of the gait cycle in individuals who underwent an AKA and are equipped with MicPK or MechPK. Methods Twenty-eight individuals participated in the study; 14 were assigned to a study group of individuals who underwent a unilateral AKA, and the other 14 were healthy participants as a control group. The movement task was recorded using the optoelectronic SMART-E system following the standard Davis protocol (the Newington model). A new method of quantifying gait symmetry using the symmetry function (SF) is proposed. SF is an integral measure of absolute differences in time-standardized signals between sides throughout the whole cycle of motion variability. Results In the frontal plane, there were significant differences between groups in the asymmetry of the range of movement in the hip joint of the intact limb. In the middle of the support phase, the intact limb was more adducted in individuals with MicPK and less abducted in people with MechPK (differences in mean 180%, p < 0.000; max 63%, p < 0.000; min 65%, p < 0.000). In the sagittal plane, the range of asymmetry of the flexion and thigh extension of the intact limb was similar to and only slightly different from the physiological gait. In the transverse plane, higher asymmetry values were noted for individuals with MicPK. In the final stage of the swing phase, the thigh was more rotated both externally and internally. The size of the asymmetry, when compared to gait of healthy individuals, reached 50% (differences in mean 115%, p < 0.232; max 62% p < 0.26; min 50, p < 0.154). Conclusions In the study group, the assessed ranges of pelvic and thigh movement in the hip joint differed only in the frontal plane. Individuals who underwent a unilateral above-knee amputation may gain less from using MicPK than anticipated.https://doi.org/10.1186/s12984-021-00810-wTransfemoral amputationSymmetry functionGait analysisBiomechanicsRehabilitation |
| spellingShingle | Mateusz Kowal Sławomir Winiarski Ewa Gieysztor Anna Kołcz Karolina Walewicz Wojciech Borowicz Alicja Rutkowska-Kucharska Małgorzata Paprocka-Borowicz Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee Journal of NeuroEngineering and Rehabilitation Transfemoral amputation Symmetry function Gait analysis Biomechanics Rehabilitation |
| title | Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| title_full | Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| title_fullStr | Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| title_full_unstemmed | Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| title_short | Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| title_sort | symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee |
| topic | Transfemoral amputation Symmetry function Gait analysis Biomechanics Rehabilitation |
| url | https://doi.org/10.1186/s12984-021-00810-w |
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