Dataset Information

The Effect of Alignment Changes on Unilateral Transtibial Amputee's Gait: A Systematic Review.

ABSTRACT:

Introduction

Prosthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputee's gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systematic review is to investigate if an optimal alignment criterion can be derived from published articles. Moreover, we investigated the effect of alignment changes on spatiotemporal, kinematic and kinetic gait parameters.

Results

A total of 11 studies were included, two controlled before-and-after studies and nine-interrupted time series studies.

Discussion

The results demonstrate that alignment changes have a predictable influence on the included kinetic parameters. However, the effect of alignment changes on spatio-temporal and kinematic gait parameters are generally unpredictable. These findings suggest that it is imperative to include kinetics in the process of dynamic prosthetic alignment. Partially this can be established by communication with the prosthetic user in terms of perceived socket comfort, but the use of measurement tools should also be considered. While current literature is not conclusive about an optimal alignment, future alignment research should focus on alignment optimisation based on kinetic outcomes.

SUBMITTER: Jonkergouw N

PROVIDER: S-EPMC5140067 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

The Effect of Alignment Changes on Unilateral Transtibial Amputee's Gait: A Systematic Review.

Jonkergouw Niels N Prins Maarten R MR Buis Arjan W P AW van der Wurff Peter P

PloS one 20161206 12

<h4>Introduction</h4>Prosthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputee's gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systemati ...[more]

PMID: 27923050

Similar Datasets

Project description:The prosthetic socket, which transfers load from the residual limb to the prosthesis, is an integral part of the prosthesis. 3D printing has emerged as a potentially viable alternative to traditional fabrication for producing sockets that effectively transfer loads. We conducted a systematic review to better understand the current state of this newer fabrication method, with a focus on the structural integrity of 3D printed sockets and factors that can affect the strength of 3D printed sockets when tested using ISO 10328 standards. Literature searches were carried out in five databases (PubMed, Scopus, CINAHL, Web of Science and Google Scholar). Two reviewers independently performed the literature selection, quality assessment, and data extraction. A total of 1023 unique studies were screened in accordance with inclusion and exclusion criteria. Of 1023 studies, 12 studies met all inclusion criteria, with failure data for 15 3D-printed sockets and 26 standard laminated sockets. Within 3D printed sockets, the addition of composite materials such as carbon fiber particles and distal reinforcement using a compositing infill technique appears to improve socket strength. In light of the considerable amount of heterogeneity between studies in terms of materials and alignment used, the absolute values for failure could not be established for 3DS nor directly compared between 3DS and LCS. However, there is some evidence that the probability of a failure at a given load may be comparable between 3DS and LCS up to the P8 level. For all sockets, whether a laminated composite socket or a 3D printed socket, failure mainly occurred at the distal end of the socket or the pyramid attachment, which is consistent with the ISO testing protocol. Improving the strength of the 3D printed sockets through design modifications at the distal end and implementing emerging printing technologies could help to promote 3D printed sockets as a viable option, particularly when cost or access to care is limited.

Project description:BackgroundThe effect of footwear on the gait of children is poorly understood. This systematic review synthesises the evidence of the biomechanical effects of shoes on children during walking and running.MethodsStudy inclusion criteria were: barefoot and shod conditions; healthy children aged ? 16 years; sample size of n > 1. Novelty footwear was excluded. Studies were located by online database-searching, hand-searching and contact with experts. Two authors selected studies and assessed study methodology using the Quality Index. Meta-analysis of continuous variables for homogeneous studies was undertaken using the inverse variance approach. Significance level was set at P < 0.05. Heterogeneity was measured by I2. Where I2 > 25%, a random-effects model analysis was used and where I2 < 25%, a fixed-effects model was used.ResultsEleven studies were included. Sample size ranged from 4-898. Median Quality Index was 20/32 (range 11-27). Five studies randomised shoe order, six studies standardised footwear. Shod walking increased: velocity, step length, step time, base of support, double-support time, stance time, time to toe-off, sagittal tibia-rearfoot range of motion (ROM), sagittal tibia-foot ROM, ankle max-plantarflexion, Ankle ROM, foot lift to max-plantarflexion, 'subtalar' rotation ROM, knee sagittal ROM and tibialis anterior activity. Shod walking decreased: cadence, single-support time, ankle max-dorsiflexion, ankle at foot-lift, hallux ROM, arch length change, foot torsion, forefoot supination, forefoot width and midfoot ROM in all planes. Shod running decreased: long axis maximum tibial-acceleration, shock-wave transmission as a ratio of maximum tibial-acceleration, ankle plantarflexion at foot strike, knee angular velocity and tibial swing velocity. No variables increased during shod running.ConclusionsShoes affect the gait of children. With shoes, children walk faster by taking longer steps with greater ankle and knee motion and increased tibialis anterior activity. Shoes reduce foot motion and increase the support phases of the gait cycle. During running, shoes reduce swing phase leg speed, attenuate some shock and encourage a rearfoot strike pattern. The long-term effect of these changes on growth and development are currently unknown. The impact of footwear on gait should be considered when assessing the paediatric patient and evaluating the effect of shoe or in-shoe interventions.

Dataset Information

The Effect of Alignment Changes on Unilateral Transtibial Amputee's Gait: A Systematic Review.

Introduction

Results

Discussion

Publications

The Effect of Alignment Changes on Unilateral Transtibial Amputee's Gait: A Systematic Review.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets