Session: CIE-13-01 CAPPD: Digital Human Modeling for Design and Manufacturing

Paper Number: 140648

140648 - Kinematic Analysis of Gait on Level and Sloping Ground With Uneven Surface in Transtibial Amputees With Exomodular Prostheses 

Objective: One major challenge encountered by exomodular prosthetic users is walking in uneven terrain and sloped surfaces. This difficulty arises from the restricted mobility of the ankle joint on the prosthetic side and the absence of distal muscles and sensory input from the lower limb. Looking forward to design prostheses that are better adapted to this type of terrains, it is necessary to establish the existing differences in the spatiotemporal variables of gait and in the kinematics of the ankle, knee and hip during walking on sloping uneven ground of transtibial amputees with exomodular prostheses and control users, in order to help identify areas where existing prostheses can be ameliorated.

Methods: An experiment was conducted with a sample of 20 transtibial amputees with exomodular prostheses and 20 control users, who walked on a platform with stones at level ground (without inclination) and in sloping ground with an inclination of 10°. Spatiotemporal measurements and ranges of motion were taken by means of noninvasive sensors. The variables were compared between the amputee group and the control group in the different ground inclinations and in the distinct phases of the gait cycle.

Results: Overall, in terms of spatiotemporal variables we found that during gait in uneven surfaces, amputee subjects reduced the gait velocity and cadence in comparison with control subjects. Lower stance time for the amputated leg and higher balance time for the healthy leg for amputees were also found. Smaller non-significant differences were found in step length, stride length and step width. 

During both the ramp-up and the ramp-down condition, amputee users showed decreased flexion than control subjects in the ankle and the knee joints during the stance phase in the prosthetic leg. This pattern of lower flexion was also seen in the single limb support in the level ground surface. In the swing phase on the other side, less flexion of the knee joint of the healthy leg of the amputees was found for level ground, ramp-up and ramp-down gait.

 

Conclusions: We found that uneven surfaces do not affect the spatiotemporal gait variables of transtibial amputees to a greater degree than control subjects, indicating that transtibial amputees have the ability to use the same strategies that able-bodied people use to cope with the gait stability and adaptability challenges generated by uneven surfaces.

In order to reduce the adaptations that amputees must use to be able to walk on these terrains, the possibility of increasing the range of motion of the foot of exomodular prostheses should be considered, so that the new prostheses adapt better to the changes of inclination and slope characteristic of the uneven terrains that are the most common in Colombia and some Latin American countries.

Presenting Author: Elizabeth Rendón Velez Universidad EAFIT

Presenting Author Biography: Elizabeth Rendón Velez is head of the Design Engineering Department and researcher of the Design Engineering Research Group GRID at Universidad EAFIT. She is a mechanical engineer with a master's degree in computer engineering from the same university. Her doctorate was done at the Delft University of Technology in the Netherlands under the tutelage of Prof. Dr. Imre Horvath, on the subject of affective computing. In his professional career he has conducted studies in the areas of computational geometry, biomedical and human factors (Man-Machine relations). Specifically, he has participated in projects related to the design of upper and lower limb prostheses and emotional sensing projects. In upper limb rehabilitation, he worked on the development of hand exoskeletons for stroke patients. In lower limb rehabilitation, he has focused on gait analysis of amputee patients when there is a relative motion between the socket and the residual motion and on the detection of abnormal gait patterns from electromyographic signals and kinematic and spatio-temporal variables.

Authors:

Mariana Franco Ochoa Universidad EAFIT
Yessika María Ortega Bedoya Universidad EAFIT
Elizabeth Rendón Velez Universidad EAFIT