Cleveland T Barnett1, Liam D Hughes1, Amy E Sullivan2, Gerda Strutzenberger3,4, Jodie L Levick1, Maria Bisele1, Alan R De Asha1,5. 1. School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom. 2. University Hospitals of Derby and Burton NHS Trust, United Kingdom. 3. Universitätsklinik Balgrist, Zürich, Switzerland. 4. Department of Sport and Exercise Science, University of Salzburg, Austria. 5. C-Motion, Inc., Germantown, Maryland.
Abstract
BACKGROUND: Ankle-foot and knee components are important determinants of mobility for individuals with transfemoral amputation. Individually, advanced ankle-foot and knee components have been shown to benefit mobility in this group of people. However, it is not clear what effect a variety of combinations of ankle-foot and knee components have on mobility test performance. OBJECTIVES: To assess whether outcomes from mobility tests in people with unilateral transfemoral amputation are influenced by varying combinations of ankle-foot and knee components. STUDY DESIGNS: Repeated measures. METHODS: Nine adults with unilateral transfemoral amputation completed the two-minute walk test, the timed up-and-go test, the L-test, and a custom locomotion course in four randomized prosthetic conditions. These conditions were each a combination of an ankle-foot component (rigid, nonarticulating [RIG] or hydraulically articulating [HYD]) and a knee component (non-microprocessor-controlled [NMPK] or microprocessor-controlled [MPK]). The test-retest reliability and concurrent validity of the custom locomotion course were also established. RESULTS: The best performance in all mobility tests was associated with the MPK + HYD combination, followed by the MPK + RIG, NMPK + HYD, and NMPK + RIG combinations. This effect was statistically significant for the two-minute walk test (P = 0.01, = 0.36) and on threshold for the L-test (P = 0.05, = 0.36), but not statistically significant for the locomotion course (P = 0.07, = 0.38) or the timed up-and-go test (P = 0.12, = 0.22). Locomotion course performance had good to excellent test-retest reliability and strong concurrent validity. CONCLUSION: Using a combination of a HYD ankle-foot and a MPK knee resulted in the highest performance in mobility tests. This was observed in contrast to combinations of prosthetic components that included a rigid ankle-foot component and/or a NMPK knee component.
BACKGROUND: Ankle-foot and knee components are important determinants of mobility for individuals with transfemoral amputation. Individually, advanced ankle-foot and knee components have been shown to benefit mobility in this group of people. However, it is not clear what effect a variety of combinations of ankle-foot and knee components have on mobility test performance. OBJECTIVES: To assess whether outcomes from mobility tests in people with unilateral transfemoral amputation are influenced by varying combinations of ankle-foot and knee components. STUDY DESIGNS: Repeated measures. METHODS: Nine adults with unilateral transfemoral amputation completed the two-minute walk test, the timed up-and-go test, the L-test, and a custom locomotion course in four randomized prosthetic conditions. These conditions were each a combination of an ankle-foot component (rigid, nonarticulating [RIG] or hydraulically articulating [HYD]) and a knee component (non-microprocessor-controlled [NMPK] or microprocessor-controlled [MPK]). The test-retest reliability and concurrent validity of the custom locomotion course were also established. RESULTS: The best performance in all mobility tests was associated with the MPK + HYD combination, followed by the MPK + RIG, NMPK + HYD, and NMPK + RIG combinations. This effect was statistically significant for the two-minute walk test (P = 0.01, = 0.36) and on threshold for the L-test (P = 0.05, = 0.36), but not statistically significant for the locomotion course (P = 0.07, = 0.38) or the timed up-and-go test (P = 0.12, = 0.22). Locomotion course performance had good to excellent test-retest reliability and strong concurrent validity. CONCLUSION: Using a combination of a HYD ankle-foot and a MPK knee resulted in the highest performance in mobility tests. This was observed in contrast to combinations of prosthetic components that included a rigid ankle-foot component and/or a NMPK knee component.
Authors: Michael McGrath; Laura A Gray; Beata Rek; Kate C Davies; Zoe Savage; Jane McLean; Alison Stenson; Saeed Zahedi Journal: PLoS One Date: 2022-09-02 Impact factor: 3.752