Factors associated with a risk of prosthetic knee buckling during walking in unilateral transfemoral amputees

Genki Hisano; Satoru Hashizume; Yoshiyuki Kobayashi; Akihiko Murai; Toshiki Kobayashi; Motomu Nakashima; Hiroaki Hobara

doi:10.1016/j.gaitpost.2020.01.002

Factors associated with a risk of prosthetic knee buckling during walking in unilateral transfemoral amputees

Gait Posture. 2020 Mar:77:69-74. doi: 10.1016/j.gaitpost.2020.01.002. Epub 2020 Jan 18.

Authors

Genki Hisano¹, Satoru Hashizume², Yoshiyuki Kobayashi³, Akihiko Murai³, Toshiki Kobayashi⁴, Motomu Nakashima², Hiroaki Hobara⁵

Affiliations

¹ Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan; Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan.
² Department of Systems and Control Engineering, Tokyo Institute of Technology, Tokyo, Japan.
³ Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan.
⁴ Department of Prosthetics and Orthotics, Faculty of Health Sciences, Hokkaido University of Science, Sapporo, Hokkaido, Japan.
⁵ Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Tokyo, Japan. Electronic address: hobara-hiroaki@aist.go.jp.

PMID: 31999980
DOI: 10.1016/j.gaitpost.2020.01.002

Abstract

Background: Walking and mobility are essential for a satisfactory quality of life. However, individuals with transfemoral amputations have difficulties in preventing falls due to prosthetic knee buckling, defined as the sudden loss of postural support during weight-bearing activities. The risk of prosthetic knee buckling can be evaluated by determining the prosthetic knee angular impulse (PKAI) during the early stance phase. However, little is known about the factors associated with PKAI in individuals with unilateral transfemoral amputations.

Research question: What are the demographic factors that can be associated with the risk of prosthetic knee buckling, quantified by PKAI, during walking in individuals with unilateral transfemoral amputations?

Methods: Thirteen individuals with unilateral transfemoral amputations were instructed to perform level walking at a comfortable, self-selected speed on a straight, 10-m walkway. PKAI was calculated as the time integral of the prosthetic knee external flexion-extension moment during the initial 40 % of the prosthetic gait cycle. We used Pearson's correlation coefficients to examine the relationship of PKAI with the following variables: the subject's body height, body mass, and age; the time since amputation; and the current prosthesis use history. Furthermore, an independentt-test was used to compare PKAI according to the sex (male vs. female) and etiology (trauma vs. nontrauma).

Results: PKAI exhibited a significant negative linear relationship with the subject's body height and body mass. However, it showed no significant correlation with age, the time since amputation, and the current prosthesis use history. It was also significantly greater in women than in men and was not significantly influenced by the etiology.

Significance: Awareness about demographic factors associated with PKAI during walking can contribute to fall assessments in gait rehabilitation programs for individuals with unilateral transfemoral amputations.

Keywords: Amputee; Angular impulse; Knee buckling; Locomotion; Prosthetic knee.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls
Adolescent
Adult
Amputation, Surgical*
Artificial Limbs*
Biomechanical Phenomena
Body Height
Body Weight
Female
Gait
Gait Analysis
Humans
Joint Instability / epidemiology*
Joint Instability / physiopathology
Knee
Knee Joint*
Male
Middle Aged
Quality of Life
Range of Motion, Articular
Sex Factors
Walking
Weight-Bearing
Young Adult