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Amputee Locomotion

Joint Moment Adaptations to Running Speed Using Running-Specific Prostheses after Unilateral Transtibial Amputation

Baum, Brian S., PhD; Hobara, Hiroaki, PhD; Koh, Kyung, PhD; Kwon, Hyun Joon, PhD; Miller, Ross H., PhD; Shim, Jae Kun, PhD

American Journal of Physical Medicine & Rehabilitation: March 2019 - Volume 98 - Issue 3 - p 182–190
doi: 10.1097/PHM.0000000000000905
Original Research Articles

Objective The objective of this study was to investigate three-dimensional lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses.

Design Eight individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/sec). A 2 × 2 × 3 (group × leg × speed) repeated-measures analysis of variance with Bonferroni adjustments determined statistical significance.

Results The prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb did. The intact limb had greater peak hip external rotation moments than control limbs did, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than in the prosthetic limb.

Conclusion Individuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs.

From the School of Physical Therapy, Regis University, Denver, Colorado (BSB); Department of Kinesiology, University of Maryland, College Park (BSB, KK, HJK, RHM, JKS); National Institute of Advanced Industrial Science and Technology, Tokyo, Japan (HH); Neuroscience and Cognitive Science Program and Fischell Department of Bioengineering, University of Maryland, College Park (JKS); and Department of Mechanical Engineering, Kyung Hee University, Yong-In, Korea (JKS).

All correspondence should be addressed to: Jae Kun Shim, PhD, Department of Kinesiology, University of Maryland, College Park, 0110 F School of Public Health (Bldg 225), 2242 Valley Dr, College Park, MD 20742.

Funded by the National Institute of Arthritis and Musculoskeletal and Skin Disease R03 Award 1R03AR062321 and the University of Maryland Department of Kinesiology Graduate Research Initiative Fund.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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