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Energy cost of ambulation in trans-tibial amputees using a dynamic-response foot with hydraulic versus rigid 'ankle': insights from body centre of mass dynamics. | LitMetric

AI Article Synopsis

  • - The study examined the benefits of using a dynamic-response prosthetic foot with a hydraulic ankle (hyA-F) versus a traditional rigid foot (rigA-F) for unilateral trans-tibial amputees, particularly focusing on metabolic energy savings and walking symmetry.
  • - Nine active amputees walked on a treadmill at various speeds and decline angles, with respirometry measuring metabolic costs and 3D motion capture analyzing movement patterns.
  • - Results showed that the hyA-F significantly reduced energy expenditure and improved walking symmetry compared to rigA-F, suggesting that this prosthetic can enhance daily mobility for amputees.

Article Abstract

Background: Previous research has shown that use of a dynamic-response prosthetic foot (DRF) that incorporates a small passive hydraulic ankle device (hyA-F), provides certain biomechanical benefits over using a DRF that has no ankle mechanism (rigA-F). This study investigated whether use of a hyA-F in unilateral trans-tibial amputees (UTA) additionally provides metabolic energy expenditure savings and increases the symmetry in walking kinematics, compared to rigA-F.

Methods: Nine active UTA completed treadmill walking trials at zero gradient (at 0.8, 1.0, 1.2, 1.4, and 1.6 of customary walking speed) and for customary walking speed only, at two angles of decline (5° and 10°). The metabolic cost of locomotion was determined using respirometry. To gain insights into the source of any metabolic savings, 3D motion capture was used to determine segment kinematics, allowing body centre of mass dynamics (BCoM), differences in inter-limb symmetry and potential for energy recovery through pendulum-like motion to be quantified for each foot type.

Results: During both level and decline walking, use of a hyA-F compared to rigA-F significantly reduced the total mechanical work and increased the interchange between the mechanical energies of the BCoM (recovery index), leading to a significant reduction in the metabolic energy cost of locomotion, and hence an associated increase in locomotor efficiency (p < 0.001). It also increased inter-limb symmetry (medio-lateral and progression axes, particularly when walking on a 10° decline), highlighting the improvements in gait were related to a lessening of the kinematic compensations evident when using the rigA-F.

Conclusions: Findings suggest that use of a DRF that incorporates a small passive hydraulic ankle device will deliver improvements in metabolic energy expenditure and kinematics and thus should provide clinically meaningful benefits to UTAs' everyday locomotion, particularly for those who are able to walk at a range of speeds and over different terrains.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417010PMC
http://dx.doi.org/10.1186/s12984-019-0508-xDOI Listing

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