{"title":"Mechanical Work and Metabolic Cost of Walking with Knee-Foot Prostheses: A Study with a Prosthesis Simulator","authors":"","doi":"10.1016/j.irbm.2024.100863","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>At equivalent speeds, above-knee amputee subjects have a higher metabolic cost than non-amputees. Following amputation, the ankle propulsion is reduced, and using other joints to compensate is mechanically less efficient.</div></div><div><h3>Objective</h3><div>This study investigated the link between mechanical work and metabolic cost in abled-bodied subjects using a prosthesis simulator, and the influence of foot energy restitution by comparing a foot with restitution to one without.</div></div><div><h3>Method</h3><div>Six volunteers fitted with an orthosis immobilising their ankle and knee, enabling the use of a prosthesis, carried out a gait analysis and an analysis of metabolic cost. The total lower limb mechanical work and works at the hip, knee and ankle were computed.</div></div><div><h3>Results</h3><div>With an almost twofold increase, metabolic cost and hip work were significantly higher in both configurations with prosthesis than without (p < 0.001 for both variables in both configurations), while total lower limb mechanical work showed no significant difference between configurations. No significant difference was observed between the two prosthetic feet in terms of metabolic cost nor mechanical work performed by the subject.</div></div><div><h3>Discussion</h3><div>Total lower limb mechanical work alone cannot explain the extra metabolic cost in subjects fitted with a knee-foot prosthesis simulator; internal inefficiencies exist. We also found that metabolic cost and hip work increase and decrease simultaneously, thus studying hip muscles work could be interesting. With no significant difference between the two feet, optimising ankle propulsion seems to be ineffective in improving metabolic cost. These findings should be evaluated in a sample of above-knee amputee subjects.</div></div>","PeriodicalId":14605,"journal":{"name":"Irbm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Irbm","FirstCategoryId":"5","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1959031824000447","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background
At equivalent speeds, above-knee amputee subjects have a higher metabolic cost than non-amputees. Following amputation, the ankle propulsion is reduced, and using other joints to compensate is mechanically less efficient.
Objective
This study investigated the link between mechanical work and metabolic cost in abled-bodied subjects using a prosthesis simulator, and the influence of foot energy restitution by comparing a foot with restitution to one without.
Method
Six volunteers fitted with an orthosis immobilising their ankle and knee, enabling the use of a prosthesis, carried out a gait analysis and an analysis of metabolic cost. The total lower limb mechanical work and works at the hip, knee and ankle were computed.
Results
With an almost twofold increase, metabolic cost and hip work were significantly higher in both configurations with prosthesis than without (p < 0.001 for both variables in both configurations), while total lower limb mechanical work showed no significant difference between configurations. No significant difference was observed between the two prosthetic feet in terms of metabolic cost nor mechanical work performed by the subject.
Discussion
Total lower limb mechanical work alone cannot explain the extra metabolic cost in subjects fitted with a knee-foot prosthesis simulator; internal inefficiencies exist. We also found that metabolic cost and hip work increase and decrease simultaneously, thus studying hip muscles work could be interesting. With no significant difference between the two feet, optimising ankle propulsion seems to be ineffective in improving metabolic cost. These findings should be evaluated in a sample of above-knee amputee subjects.
期刊介绍:
IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux).
As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in:
-Physiological and Biological Signal processing (EEG, MEG, ECG…)-
Medical Image processing-
Biomechanics-
Biomaterials-
Medical Physics-
Biophysics-
Physiological and Biological Sensors-
Information technologies in healthcare-
Disability research-
Computational physiology-
…