Julia A. Dunn , Nicholas G. Gomez , Bob Wong , Sarina K. Sinclair , K. Bo Foreman , Kent N. Bachus , Heath B. Henninger
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Abstract
Background
Individuals with transhumeral limb loss have an increased risk of falling, potentially resulting from altered upper-body kinematics during gait. The purpose of this study was to investigate whole-body angular momentum as a measure of movement control, to gain an understanding of how these upper-body kinematics contribute to dynamic balance.
Methods
Eight participants with transhumeral limb loss and eight able-bodied control participants completed three gait trials at self-selected speeds. The participants with transhumeral limb loss performed trials with and without their prosthesis. Coefficient of cancellation and whole-body angular momentum about all anatomical axes of rotation were calculated. Means and variance were compared across the conditions over the gait cycle via statistical parametric mapping, and ranges were compared using a one-way ANOVA.
Findings
Coefficient of cancellation was decreased between the upper/lower extremities in the transverse plane and between the upper extremities/trunk in the sagittal plane for both transhumeral walking conditions compared to the control group. Whole-body angular momentum was statistically different in the sagittal plane and decreased in the transverse plane when walking with the prosthesis compared to the control group. Walking without the prosthesis resulted in increased variability of whole-body angular momentum.
Interpretation
Individuals with transhumeral limb loss had dysregulated whole-body angular momentum compared to the control group. This dysregulation was related to decreased segment-to-segment cancellation from the upper extremities and increased variance throughout the gait cycle. Based on these findings, individuals should be encouraged to wear their transhumeral prosthesis while walking as it may reduce fall risk and fatigue.
期刊介绍：
Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field.
The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management.
A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly.
Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians.
The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time.
Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.
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