medigraphic.com
ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2024, Number 1-3

<< Back Next >>

Rev Mex Ortop Ped 2024; 26 (1-3)

Utility of the motion analysis laboratory in the detection of alignment alterations in patients with transtibial prostheses

Arenas-Díaz AL, Capdevila-Leonori R, Barrón-Torres EA, Hernández-Gómez C, Molina-Montaño EG, Guzmán-Martín CA

Language: Spanish
References: 14
Page: 19-24
PDF size: 240.38 Kb.


ABSTRACT

The musculoskeletal system loses components with amputation, which is often seen as a catastrophe by both the family and the child. This leads to a partial loss of function. A study aimed to assess the use of laboratory gait analysis in aligning prosthetics for pediatric patients with coronal plane deformities (varus/valgus) and transtibial amputation. The study included 26 patients, with 57.6% undergoing right leg amputation and 42.3% undergoing left leg amputation. Before alignment, the average speed of the patients was 0.914 m/s, which improved to 0.91 m/s after alignment adjustment. There was an increase in step length from 0.53 m to 0.54 m after adjustment, while differences in the number of steps per minute and distance traveled were not significant. In terms of knee deformities, there was a 75% improvement in valgus deformities after adjustment, which was statistically significant (p = 0.05). Alignment of the prosthesis also had significant effects on pelvic inclination and obliquity, especially in cases of valgus. The study concluded that gait analysis in patients with transtibial prostheses provides a deeper understanding of the body's adaptation strategies, aiding in correcting angular deformities and improving pelvic stability. The study also demonstrated that fine-tuning prosthetic alignment not only improves knee biomechanics but also positively impacts pelvic symmetry.


REFERENCES

  1. Van Velzen JM, Houdijk H, Polomski W, Van Bennekom CA. Usability of gait analysis in the alignment of trans-tibial prostheses: a clinical study. Prosthet Orthot Int. 2005; 29 (3): 255-267.

  2. Griffet J. Amputation and prosthesis fitting in paediatric patients. Orthop Traumatol Surg Res. 2016; 102(1 Suppl): S161-175.

  3. Eshraghi A, Abu Osman NA, Karimi M, Gholizadeh H, Soodmand E, Wan Abas WA. Gait biomechanics of individuals with transtibial amputation: effect of suspension system. PLoS One. 2014; 9(5): e96988.

  4. Hafner BJ, Sanders JE, Czerniecki JM, Fergason J. Transtibial energy-storage-and-return prosthetic devices: a review of energy concepts and a proposed nomenclature. J Rehabil Res Dev. 2002; 39(1): 1-11.

  5. Marinakis GN. Interlimb symmetry of traumatic unilateral transtibial amputees wearing two different prosthetic feet in the early rehabilitation stage. J Rehabil Res Dev. 2004; 41(4): 581-590.

  6. Blumentritt S, Schmalz T, Jarasch R. Die Bedeutung des statischen Prothesenaufbaus für das Stehen und Gehen des Unterschenkelamputierten [Significance of static prosthesis alignment for standing and walking of patients with lower limb amputation]. Orthopade. 2001;30(3):161-168.

  7. Culham EG, Peat M, Newell E. Below-knee amputation: a comparison of the effect of the SACH foot and single axis foot on electromyographic patterns during locomotion. Prosthet Orthot Int. 1986;10(1):15-22.

  8. Boone DA, Kobayashi T, Chou TG, Arabian AK, Coleman KL, Orendurff MS, Zhang M. Influence of malalignment on socket reaction moments during gait in amputees with transtibial prostheses. Gait Posture. 2013; 37(4): 620-626.

  9. Pitkin MR. Effects of design variants in lower-limb prostheses on gait synergy. J Prosthet Orthot. 1997; 9(3): 113-122.

  10. Rusaw D, Ramstrand N. Motion-analysis studies of transtibial prosthesis users: a systematic review. Prosthet Orthot Int. 2011; 35(1): 8-19.

  11. Rietman JS, Postema K, Geertzen JH. Gait analysis in prosthetics: opinions, ideas and conclusions. Prosthet Orthot Int. 2002; 26(1): 50-57.

  12. Fitzsimons T, Clark A, Symonds A, Navarrete M, Saad N, Fitzsimons T et al. Physiotherapy following lower limb amputation. Physiotherapy Departments in SWAHS-Western Cluster, 2006, pp. 66-82.

  13. Hannah RE, Morrison JB, Chapman AE. Prostheses alignment: effect on gait of persons with below-knee amputations. Arch Phys Med Rehabil. 1984;65(4):159-162.

  14. Raschke SU, Orendurff MS, Mattie JL, Kenyon DE, Jones OY, Moe D et al. Biomechanical characteristics, patient preference and activity level with different prosthetic feet: a randomized double blind trial with laboratory and community testing. J Biomech. 2015; 48 (1): 146-152.



EVIDENCE LEVEL

III




2020     |     www.medigraphic.com