Ideal operating conditions for a variable stiffness transverse plane adapter for individuals with lower-limb amputation |
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| Affiliation: | 1. Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT 59715, United States;2. Department of Mechanical Engineering, Colorado School of Mines, Golden, CO 80401, United States;3. Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX 78712, United States;4. Department of Mechanical Engineering, University of Washington, Seattle, WA 98195, United States;5. Department of Veterans Affairs Center for Limb Loss and Mobility, Seattle, WA 98108, United States;1. Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA;2. DoD-VA Extremity Trauma and Amputation Center of Excellence, USA;3. Department of Surgery, Uniformed Services University of the Health Sciences & Walter Reed National Military Medical Center, Bethesda, MD, USA;4. Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA;1. Center for Applied Biomechanics and Rehabilitation Research, MedStar National Rehabilitation Hospital, Washington, DC 20010, USA;2. Department of Biomedical Engineering, Catholic University of America, Washington, DC 20064, USA;3. Center for Brain Plasticity and Recovery, Georgetown University, Washington, DC 20057, USA;4. Human Motor Control Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20814, USA;1. Orthopedie Techniek Aardenburg, Military Rehabilitation Centre Aardenburg, Doorn, The Netherlands;2. Department of Research and Development, Military Rehabilitation Centre Aardenburg, Doorn, The Netherlands;3. Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, The Netherlands;4. Department of Biomedical Engineering, Faculty of Biomechanical Engineering, University of Strathclyde, Glasgow, Scotland, United Kingdom;5. Institute for Human Movement Studies, HU University of Applied Sciences Utrecht, The Netherlands;6. Motek Medical, Amsterdam, The Netherlands;7. Department of Research and Development, Heliomare, Wijk aan Zee, The Netherlands;1. Department of Kinesiology, Pennsylvania State University, University Park, PA 16802, USA;2. Department of Engineering Science & Mechanics, Pennsylvania State University, University Park, PA 16802, USA;1. University of Denver, Human Dynamics Laboratory, Denver, CO, United States;2. University of Colorado Denver, Dept. of Physical Medicine & Rehabilitation, Aurora, CO, United States;3. VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO, United States |
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| Abstract: | Transverse plane shear stress between the prosthetic socket and residual limb often results in soft tissue breakdown and discomfort for individuals with lower-limb amputation. To better understand the effects of reduced transverse plane stiffness in the shank of a prosthesis, a second-generation variable stiffness torsion adapter (VSTA II) was tested with individuals with a transtibial amputation (n = 10). Peak transverse plane moments, VSTA II deflection, range of whole body angular momentum (WBAM), ground reaction impulse, joint work, and personal stiffness preference were evaluated at three fixed stiffness levels (compliant: 0.25 Nm/°, intermediate: 0.75 Nm/°, stiff: 1.25 Nm/°) at three walking speeds (self-selected, fast and slow: +/− 20% of self-selected, respectively) while straight-line walking and performing left and right turns. Residual limb loading decreased and VSTA II displacement increased for reductions in stiffness and both metrics increased with increasing walking speed, while ground reaction impulse and joint work were unaffected. The range of WBAM increased with decreased stiffness, which suggests an increased risk of falling when using the VSTA II at lower stiffness settings. Preference testing showed no significant result, but trends for lower stiffness settings when turning and walking at self-selected speeds were noted, as were stiffer settings when walking straight and at faster speeds. These results show that a device with rotational compliance like the VSTA II could reduce loading on the residual limb during straight walking and turning activities and that factors such as walking speed, activity type and user preference can affect the conditions for optimal use. |
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| Keywords: | Turning Below-knee amputee Prosthesis Torsion adapter Gait Biomechanics |
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