Document Detail

Altered kinetic strategy for the control of swing limb elevation over obstacles in unilateral below-knee amputee gait.
MedLine Citation:
PMID:  10327009     Owner:  NLM     Status:  MEDLINE    
Our goal was to document the kinetic strategies for obstacle avoidance in below-knee amputees. Kinematic data were collected as unilateral below-knee traumatic amputees stepped over obstacles of various heights in the walking path. Inverse dynamics were employed to calculate power profiles and work during the limb-elevation and limb-lowering phases. Limb elevation was achieved by employing a different strategy of intra-limb interaction for elevation of the prosthetic limb than for the sound limb, which was similar to that seen in healthy adult non-amputees. As obstacle height increased, prosthetic side knee flexion was increased by modulating the work done at the hip, and not the knee, as seen on the sound side. Although the strength of the muscles about the residual knee was preserved, the range of motion of that knee had previously been found to be somewhat limited. Perhaps more importantly, potential instability of the interface between the stump and the prosthetic socket, and associated discomfort at the stump could explain the altered limb-elevation strategy. Interestingly, the limb-lowering strategy seen in the sound limb and in non-amputees already features modulation of rotational and translational work at the hip, so an alternate strategy was not required. Thus, following a major insult to the sensory and neuromuscular system, the CNS is able to update the internal model of the locomotor apparatus as the individual uses the new limb in a variety of movements, and modify control strategies as appropriate.
S W Hill; A E Patla; M G Ishac; A L Adkin; T J Supan; D G Barth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of biomechanics     Volume:  32     ISSN:  0021-9290     ISO Abbreviation:  J Biomech     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-25     Completed Date:  1999-06-25     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  545-9     Citation Subset:  IM    
Department of Kinesiology, University of Waterloo, Ontario, Canada.
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MeSH Terms
Adaptation, Physiological
Amputation Stumps / physiopathology
Artificial Limbs*
Gait / physiology*
Hip Joint / physiology
Knee Joint / physiology
Leg / physiology*
Muscle Contraction / physiology
Neuromuscular Junction / physiology
Pain / physiopathology
Prosthesis Design
Range of Motion, Articular / physiology
Surface Properties
Walking / physiology*
Work / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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