The biomechanical response of persons with transfemoral amputation to variations in prosthetic knee alignment during level walking

Sara R. Koehler-McNicholas*, Robert D. Lipschutz, Steven A. Gard

*Corresponding author for this work

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Prosthetic alignment is an important factor in the overall fit and performance of a lower-limb prosthesis. However, the association between prosthetic alignment and control strategies used by persons with transfemoral amputation to coordinate the movement of a passive prosthetic knee is poorly understood. This study investigated the biomechanical response of persons with transfemoral amputation to systematic perturbations in knee joint alignment during a level walking task. Quantitative gait data were collected for three alignment conditions: bench alignment, 2 cm anterior knee translation (ANT), and 2 cm posterior knee translation (POST). In response to a destabilizing alignment perturbation (i.e., the ANT condition), participants significantly increased their early-stance hip extension moment, confirming that persons with transfemoral amputation rely on a hip extensor strategy to maintain knee joint stability. However, participants also decreased the rate at which they loaded their prosthesis, decreased their affected-side step length, increased their trunk flexion, and maintained their prosthesis in a more vertical posture at the time of opposite toe off. Collectively, these results suggest that persons with transfemoral amputation rely on a combination of strategies to coordinate stance-phase knee flexion. Further, comparatively few significant changes were observed in response to the POST condition, suggesting that a bias toward posterior alignment may have fewer implications in terms of stance-phase, knee joint control.

Original languageEnglish (US)
Pages (from-to)1089-1106
Number of pages18
JournalJournal of rehabilitation research and development
Volume53
Issue number6
DOIs
StatePublished - Jan 1 2016

Keywords

  • Alignment
  • Amputation
  • Artificial limbs
  • Gait analysis
  • Hip
  • Knee
  • Load cell
  • Transfemoral
  • Treadmill
  • Trunk

ASJC Scopus subject areas

  • Rehabilitation

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