Altered cumulative joint moments and increased joint moment symmetry during sit-to-stand transitions for transfemoral bone-anchored limb users: A case series
Peter B. Thomsen-Freitas , Jason W. Stoneback , James B. Tracy , Mohamed E. Awad , Danielle H. Melton , Brecca M.M. Gaffney , Cory L. Christiansen
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引用次数: 0
Abstract
Background
Sit-to-stand transitions are demanding activities for people with unilateral transfemoral amputation. Movement asymmetries during sit-to-stand place greater stresses on the intact limb joints compared to the amputated limb joints, potentially contributing to musculoskeletal overuse injury and pain. Bone-anchored limbs address socket-related prosthesis issues, but their impact on cumulative joint moments during sit-to-stand is yet to be fully understood. The purpose of this study was to investigate changes in cumulative joint moments and moment symmetry during sit-to-stand transitions among transfemoral bone-anchored limb users.
Methods
A case-series of eight participants who underwent secondary bone-anchored limb implantation surgery were included. Ten consecutive days of physical activity monitoring (daily sit-to-stand) and motion capture during a 5-times sit-to-stand task were collected preoperatively (using socket prosthesis) and 12-months postoperatively. Cumulative low back, hip, and knee joint moments ([absolute joint moment impulse] x [average daily sit-to-stand]) were calculated. Between-limb symmetry was assessed using the Normalized Symmetry Index. Longitudinal changes in cumulative joint moments and moment symmetry were estimated with Hedge's g effect sizes.
Findings
Medium-to-large effects (g > 0.5) were observed for increased frontal-plane amputated-limb hip moment and increased sagittal-plane cumulative low back and intact-limb knee moments. Small-to-medium effects (g < 0.5) were observed for improved between-limb frontal-plane hip moment symmetry.
Interpretation
Despite improved between-limb symmetry, persistent overloading of the intact limb was present one-year after bone-anchored limb implantation. Changes in loading without meaningful changes in average number of daily sit-to-stands suggest potential needs for advanced prosthetic component prescription and more effective movement pattern training for bone-anchored limb users.
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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