Obstacle crossing behaviour in transfemoral prosthesis users: The effect of prosthetic componentry

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-08-12 DOI:10.1016/j.clinbiomech.2025.106649

L.D. Hughes , A.E. Hafesji-Wade , J.L. Levick , M. Bisele , C.T. Barnett

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Abstract

Background

Functionally advanced prosthetic ankle-foot and knee components have separately been shown to positively affect obstacle crossing in individuals with a transfemoral amputation. It is unknown, however, what effect combining functionally advanced components has on transfemoral prosthesis users' obstacle-crossing strategies. The study aimed to assess how different knee and ankle-foot prosthetic components influence obstacle-crossing strategies in unilateral transfemoral prosthesis users.

Methods

Individuals with a unilateral transfemoral amputation (n = 9) crossed an obstacle (30 cm × 10 cm × 8 cm) placed along an 8.3 m walkway. This was completed in four different prosthetic conditions: a combination of two different knee components (microprocessor and non-microprocessor) with one of two ankle-foot components (rigidly or hydraulically articulating ankles). Full-body kinematics were recorded as participants crossed the obstacles.

Findings

Obstacle-crossing strategies were not influenced by the prosthetic component combination. Although small changes were observed in kinematics (joint angles and centre of mass movement) and outcomes such as toe clearance and foot placement, these differences were not statistically significant.

Interpretation

When using different combinations of prosthetic ankle-foot and knee components, lower limb transfemoral prosthesis users make very small changes to movements during obstacle crossing. Obstacle-crossing strategies and outcomes are also not highly influenced by manipulating component use, suggesting relatively high neuromotor flexibility in established unilateral transfemoral prosthesis users when crossing a small obstacle.

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股骨假体使用者的过障行为：假体组件的影响

功能先进的假肢踝足和膝关节组件分别被证明对经股截肢患者的障碍穿越有积极影响。然而，结合功能先进的组件对经股假体使用者的过障策略有什么影响尚不清楚。本研究旨在评估不同的膝关节和踝足假体组件如何影响单侧经股假体使用者的过障策略。方法单侧经股截肢患者（n = 9）穿过8.3 m人行道上放置的障碍物（30 cm × 10 cm × 8 cm）。这是在四种不同的假肢条件下完成的：两种不同的膝关节组件（微处理器和非微处理器）与两种踝关节-足组件（刚性或液压关节脚踝）中的一种的组合。当参与者越过障碍物时，记录全身运动学。结果表明，人工假体组件组合对跨障策略无明显影响。虽然在运动学（关节角度和质心运动）和脚趾间隙和足部位置等结果上观察到微小的变化，但这些差异在统计学上并不显著。当使用假肢踝足和膝关节组件的不同组合时，下肢经股假体使用者在跨越障碍时对运动做出非常小的改变。操纵组件的使用对过障策略和结果也没有太大影响，这表明单侧股骨假体使用者在过小障碍物时神经运动灵活性相对较高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

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.