scholarly journals Postural Stability Characteristics of Transtibial Amputees Wearing Different Prosthetic Foot Types When Standing on Various Support Surfaces

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nooranida Arifin ◽  
Noor Azuan Abu Osman ◽  
Sadeeq Ali ◽  
Hossein Gholizadeh ◽  
Wan Abu Bakar Wan Abas
Keyword(s):  
Postural Stability ◽  
Frontal Plane ◽  
Stability Index ◽  
Prosthetic Foot ◽  
Compliant Surface ◽  
Rehabilitation Programs ◽  
Unstable Support ◽  
Support Surfaces ◽  
Mediolateral Stability ◽  
Transtibial Amputees

Purpose. This study aimed to evaluate the effects of prosthetic foot types on the postural stability among transtibial amputees when standing on different support surfaces.Materials and Methods. The postural stability of 10 transtibial amputees wearing solid ankle cushion heel (SACH) foot, single-axis (SA) foot, and energy-saving and return (ESAR) foot was assessed. Results were compared with able-bodied participants. Anterior-posterior stability index (APSI), mediolateral stability index (MLSI), and overall stability index (OSI) were measured by computed posturography in an upright stance on firm, foam, and unstable support surfaces.Results. The mean OSI score of SACH foot was significantly lower than that of an ESAR foot when the participants were standing on a compliant surface. When compared to able-bodied group, MLSI score was significantly higher for each of the prosthetic foot groups while OSI score was significantly higher for ESAR foot only in foam condition.Conclusions. Differences between prosthetic foot types and groups (amputees versus able-bodied) can only be distinguished when individuals were standing on a compliant surface. Amputees exhibited an increased postural instability in the mediolateral direction than able-bodied individuals. Hence, the restoration of stability in the frontal plane and the enhancement of proprioception at the residual limb should be the basis of rehabilitation programs.

POSTURAL STABILITY STRATEGIES IN TRANSTIBIAL AMPUTEES DURING QUIET STANDING IN ALTERED SENSORY CONDITIONS WEARING THREE TYPES OF PROSTHETIC FEET

2020 ◽  
Vol 20 (02) ◽  
pp. 1950071
Author(s):  
NOORANIDA ARIFIN ◽  
NOOR AZUAN ABU OSMAN ◽  
SADEEQ ALI
Keyword(s):  
Postural Stability ◽  
Quiet Standing ◽  
Lateral Direction ◽  
Prosthetic Foot ◽  
Compliant Surface ◽  
Eyes Closed ◽  
Strong Positive Relationship ◽  
Movement Strategy ◽  
Prosthetic Feet ◽  
Transtibial Amputees

Individuals with transtibial amputation exhibit altered movement strategy to sustain stability during quiet standing due to reduced proprioception on the amputated limb. The aim of this study is to determine the movement strategies in anterior–posterior and medial–lateral directions in predicting the overall postural stability. In this crossover study, postural stability of ten transtibial amputees was assessed using computed posturography while wearing different prosthetic foot types: solid ankle cushion heel (SACH), single axis (SA) and energy storage and return (ESAR). Three stability indices were measured during four conditions: standing with eyes opened and closed, standing on compliant surface and standing with tilted head. From the standard multiple regression analysis, 63% to 99% of the OSI score in all sensory conditions were explained from the MLSI score, while 11% to 56% from the APSI score. The Pearson’s [Formula: see text] indicated significant strong positive relationship between OSI and MLSI [Formula: see text]–[Formula: see text] during all sensory conditions. The APSI score was significantly lower than OSI during eyes-closed and head extended conditions for all prosthetic feet [Formula: see text]. Adjustments in postural stability strategies in transtibial amputees mostly occurred in medial–lateral direction regardless of prosthetic feet types and altered sensory conditions.

scholarly journals Static balance and proprioception evaluation in deaf national basketball players

2021 ◽  
Vol 13 (1) ◽  
pp. 9-15
Author(s):  
GAMZE COBANOGLU ◽  
SINEM SUNER-KEKLIK ◽  
CAGATAY GOKDOGAN ◽  
NIHAN KAFA ◽  
SEYFI SAVAS ◽  
...  
Keyword(s):  
Postural Stability ◽  
Stability Index ◽  
Normal Hearing ◽  
Static Balance ◽  
Basketball Players ◽  
Anatomical Structures ◽  
Balance System ◽  
Significant Difference ◽  
Mediolateral Stability ◽  
Dominant Side

Background: ‪Because of the proximity of anatomical structures involved in auditory and vestibular functions, complications concerning the inner ear may lead to problems involving both systems. This study investigated whether static balance and knee proprioception in deaf basketball players are different from those in individuals with normal hearing. Material and methods: ‪12 deaf national basketball players and 13 individuals with normal hearing were included. Static balance was evaluated using the Biodex-BioSway Balance System. Knee proprioception was assessed using a Dualer IQ Digital Inclinometer with the active angle repetition test. Results: ‪The dominant-side mediolateral stability index and non-dominant-side overall, anteroposterior, and mediolateral stability index scores of deaf basketball players in the postural stability test were different compared with those of the individuals with normal hearing (p<0.05). There was no statistically significant difference between the two groups in terms of knee proprioception (p>0.05). Conclusions: ‪Although there was no difference in knee proprioception in deaf basketball players, it is noteworthy that their postural stability was more impaired compared with that in individuals with normal hearing. Despite regular exercise, deaf basketball players had poorer balance than individuals with normal hearing. Therefore, balance and vestibular exercises should be added to the training programs of these athletes.

The Effects of Instruction Exercises on Performance and Kinetic Factors Associated With Lower-Extremity Injury in Landing After Volleyball Blocks

2020 ◽  
Vol 29 (1) ◽  
pp. 51-64
Author(s):  
Anis Rostami ◽  
Amir Letafatkar ◽  
Alli Gokeler ◽  
Mehdi Khaleghi Tazji
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Postural Stability ◽  
Cruciate Ligament ◽  
Stability Index ◽  
Lower Extremity Injury ◽  
Ligament Injury ◽  
Hop Test ◽  
Anterior Cruciate ◽  
Dynamic Postural Stability

Context: Female volleyball players are more predisposed to anterior cruciate ligament injury in comparison with their male counterparts. Recent research on anterior cruciate ligament injury prevention strategies has shown the positive results of adopting the external focus (EF) of attention in sports. Objective: To determine the effect of 6-week EF instruction exercises on performance and kinetic factors associated with lower-extremity injury in landing after the volleyball blocks of female athletes. Design: Pretest and posttest control study. Setting: University research laboratory. Participants: Thirty-two female volleyball players (18–24 y old) from the same team randomly divided into experimental (n = 16) and control (n = 16) groups. Intervention: The experimental group performed a 6-week exercise program with EF instructions. The control group continued its regular volleyball team schedule. Main Outcome Measures: To assess function, single-leg triple hop test for distance was used. A force plate was used to evaluate kinetic variables including vertical ground reaction forces, the rate of loading, and dynamic postural stability index. All data were assessed at baseline and after the intervention. Results: There was a significant increase in single-leg triple hop test (P < .05) and in the first and second peak ground reaction force, rate of loadings, dynamic postural stability index (P < .05). Conclusion: According to the results of this study, anterior cruciate ligament injury prevention programs should incorporate EF instruction exercises to enhance the kinetics and to increase athletes’ functional performance.

scholarly journals Validity and Reliability of a Smartphone App for Gait and Balance Assessment

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 124
Author(s):  
Usman Rashid ◽  
David Barbado ◽  
Sharon Olsen ◽  
Gemma Alder ◽  
Jose L. L. Elvira ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Postural Stability ◽  
Step Length ◽  
Repetition Effect ◽  
Validity And Reliability ◽  
Balance Assessment ◽  
Compliant Surface ◽  
Eyes Closed ◽  
Straight Line ◽  
Gait Parameters

Advances in technology provide an opportunity to enhance the accuracy of gait and balance assessment, improving the diagnosis and rehabilitation processes for people with acute or chronic health conditions. This study investigated the validity and reliability of a smartphone-based application to measure postural stability and spatiotemporal aspects of gait during four static balance and two gait tasks. Thirty healthy participants (aged 20–69 years) performed the following tasks: (1) standing on a firm surface with eyes opened, (2) standing on a firm surface with eyes closed, (3) standing on a compliant surface with eyes open, (4) standing on a compliant surface with eyes closed, (5) walking in a straight line, and (6) walking in a straight line while turning their head from side to side. During these tasks, the app quantified the participants’ postural stability and spatiotemporal gait parameters. The concurrent validity of the smartphone app with respect to a 3D motion capture system was evaluated using partial Pearson’s correlations (rp) and limits of the agreement (LoA%). The within-session test–retest reliability over three repeated measures was assessed with the intraclass correlation coefficient (ICC) and the standard error of measurement (SEM). One-way repeated measures analyses of variance (ANOVAs) were used to evaluate responsiveness to differences across tasks and repetitions. Periodicity index, step length, step time, and walking speed during the gait tasks and postural stability outcomes during the static tasks showed moderate-to-excellent validity (0.55 ≤ rp ≤ 0.98; 3% ≤ LoA% ≤ 12%) and reliability scores (0.52 ≤ ICC ≤ 0.92; 1% ≤ SEM% ≤ 6%) when the repetition effect was removed. Conversely, step variability and asymmetry parameters during both gait tasks generally showed poor validity and reliability except step length asymmetry, which showed moderate reliability (0.53 ≤ ICC ≤ 0.62) in both tasks when the repetition effect was removed. Postural stability and spatiotemporal gait parameters were found responsive (p < 0.05) to differences across tasks and test repetitions. Along with sound clinical judgement, the app can potentially be used in clinical practice to detect gait and balance impairments and track the effectiveness of rehabilitation programs. Further evaluation and refinement of the app in people with significant gait and balance deficits is needed.

Relationship between dynamic foot-ground contact area and balance impairments in adolescents with down syndrome

2021 ◽  
pp. 1-8
Author(s):  
Mohamed E. Khallaf ◽  
Eman Fayed ◽  
Radwa E. Sweif ◽  
Abdulkarem Alsalem
Keyword(s):  
Down Syndrome ◽  
Contact Area ◽  
Postural Stability ◽  
Stability Index ◽  
Ground Contact ◽  
Balance System ◽  
Pressure Sensitive ◽  
Foot Problems ◽  
Arch Index ◽  
Biodex Balance System

PURPOSE: Down Syndrome (DS) is characterized by intellectual disability, hypotonia, and joint laxity. Physical disability can be an additional problem and manifests as reduced lower limb muscle strength and impaired balance. The objectives of this study were to characterize DS dynamic foot-ground contact area and to study its relationship with balance impairment among adolescents with DS. METHODS: Twenty-eight children and adolescents with DS and 28 non-DS adolescents/children were matched for age and sex. The Oxford Ankle Foot Questionnaire (parents’ version) was used to measure disability related to ankle/foot problems in all subjects. A pressure-sensitive mat was used to assess the contact area and arch index. Also, a Biodex balance system was used for measuring postural stability. RESULTS: There were significant differences between both groups in all domains of the Oxford Ankle Foot Questionnaire, overall contact area, and arch index (p <  0.05). Overall postural stability index was significantly decreased in subjects with DS (p <  0.05). There was a nonsignificant correlation between contact area and postural stability (p >  0.05). CONCLUSION: Adolescents with DS exhibited larger mid-foot and forefoot contact areas with respect to non-DS matched children. Impairment of balance in adolescents with DS is a multifactorial problem not related to changes in the foot contact area.

Characterizing adaptations of prosthetic feet in the frontal plane

2020 ◽  
Vol 44 (4) ◽  
pp. 225-233
Author(s):  
Michael Ernst ◽  
Björn Altenburg ◽  
Thomas Schmalz
Keyword(s):  
Energy Storage ◽  
Theoretical Model ◽  
Ankle Joint ◽  
Frontal Plane ◽  
Measured Data ◽  
Limb Amputation ◽  
Clinical Parameters ◽  
Mechanical Adaptation ◽  
Prosthetic Foot ◽  
Prosthetic Feet

Background: Energy-storage and return feet incorporate various design features including split toes. As a potential improvement, an energy-storage and return foot with a dedicated ankle joint was recently introduced allowing for easily accessible inversion/eversion movement. However, the adaptability of energy-storage and return feet to uneven ground and the effects on biomechanical and clinical parameters have not been investigated in detail. Objectives: To investigate the design-related ability of prosthetic feet to adapt to cross slopes and derive a theoretical model. Study design: Mechanical testing and characterization. Methods: Mechanical adaptation to cross slopes was investigated for six prosthetic feet measured by a motion capture system. A theoretical model linking the measured data with adaptations is proposed. Results: The type and degree of adaptation depends on the foot design, for example, stiffness, split toe or continuous carbon forefoot, and additional ankle joint. The model used shows high correlations with the measured data for all feet. Conclusions: The ability of prosthetic feet to adapt to uneven ground is design-dependent. The split-toe feet adapted better to cross slopes than those with continuous carbon forefeet. Joints enhance this further by allowing for additional inversion and eversion. The influence on biomechanical and clinical parameters should be assessed in future studies. Clinical relevance Knowing foot-specific ability to adapt to uneven ground may help in selecting an appropriate prosthetic foot for persons with a lower limb amputation. Faster and more comprehensive adaptations to uneven ground may lower the need for compensations and therefore increase user safety.

scholarly journals Poorer dynamic postural stability in patients with anterior cruciate ligament rupture combined with lateral meniscus tear than in those with medial meniscus tear

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Jin Hyuck Lee ◽  
Dae-Hee Lee ◽  
Jong-Hoon Park ◽  
Dong Won Suh ◽  
Eunseon Kim ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Postural Stability ◽  
Lateral Meniscus ◽  
Stability Index ◽  
Acl Rupture ◽  
Meniscus Tear ◽  
Significant Difference ◽  
Knee Muscle ◽  
Dynamic Postural Stability ◽  
Knee Muscle Strength

Abstract Background Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)-injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups. Methods Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anterior–posterior stability index (APSI), and medial–lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device. Results In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05). Conclusion Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear. Level of evidence: Level III

Compromised Dynamic Postural Stability Under Increased Load Carriage Magnitudes

2020 ◽  
Vol 36 (1) ◽  
pp. 27-32
Author(s):  
Alice D. LaGoy ◽  
Caleb Johnson ◽  
Katelyn F. Allison ◽  
Shawn D. Flanagan ◽  
Mita T. Lovalekar ◽  
...  
Keyword(s):  
Body Weight ◽  
Postural Stability ◽  
Reaction Force ◽  
Stability Index ◽  
Load Carriage ◽  
Men And Women ◽  
Similar Performance ◽  
The Impact ◽  
Dynamic Postural Stability ◽  
Force Data

Warfighter performance may be compromised through the impact of load carriage on dynamic postural stability. Men and women may experience this impact to differing extents due to postural stability differences. Therefore, the authors investigated the effect of load magnitude on dynamic postural stability in men and women during a landing and stabilization task. Dynamic postural stability of 32 subjects (16 women) was assessed during the unilateral landing of submaximal jumps under 3 load conditions: +0%, +20%, and +30% body weight. Dynamic postural stability was measured using the dynamic postural stability index, which is calculated from ground reaction force data sampled at 1200 Hz. Two-way mixed-measures analysis of variance compared dynamic postural stability index scores between sexes and loads. Dynamic postural stability index scores were significantly affected by load (P = .001) but not by sex or by the sex by load interaction (P > .05). Dynamic postural stability index scores increased between the 0% (0.359 ± 0.041), 20% (0.396 ± 0.034), and 30% (0.420 ± 0.028) body weight conditions. Increased load negatively affects dynamic postural stability with similar performance decrements displayed by men and women. Men and women warfighters may experience similar performance decrements under load carriage conditions of similar relative magnitudes.

scholarly journals The Development of a Rapid Prototyping Prosthetic Socket Coated with a Resin Layer for Transtibial Amputees

2010 ◽  
Vol 34 (1) ◽  
pp. 37-45 ◽  
Author(s):  
L. H. Hsu ◽  
G. F. Huang ◽  
C. T. Lu ◽  
D. Y. Hong ◽  
S. H. Liu
Keyword(s):  
Rapid Prototyping ◽  
Fused Deposition Modeling ◽  
Polyester Resin ◽  
Unsaturated Polyester ◽  
Unsaturated Polyester Resin ◽  
Forming Process ◽  
Prosthetic Foot ◽  
Fused Deposition ◽  
Prosthetic Socket ◽  
Transtibial Amputees

This article proposes a type of transtibial socket composed of an inner layer fabricated by a rapid prototyping (RP) machine and an outer layer coated with unsaturated polyester resin. This work integrates contemporary technologies including a handheld scanner and CAD systems, to design a thin primary socket shape and then manufactures the socket using a fused deposition-modeling machine. To prevent breakage caused by the layer-based forming process and to reinforce flexural strength, the current research coats the preliminary RP socket with a layer of unsaturated polyester resin. After shaping the proximal brim of the resin-reinforced RP socket to match the specific stump, this study assembles and aligns a shank and a prosthetic foot to form a prosthesis set. After completing a trial safety walk wearing the prosthesis, which is satisfactory to the amputee and a registered prosthetist, this research measures interface pressures between the stump and the resin-reinforced RP socket. Experiment results demonstrate that the resin-reinforced RP socket is applicable for transtibial amputees. In addition to strengthening the FDM socket and producing consistent socket fit, this study also demonstrates a feasible procedure that employs current technologies to design and manufacture transtibial sockets without plaster moulds.

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