Gait energy consumption and gait efficiency with two different models of prosthetics knees: a single case report

Authors

  • Catarina Sá Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.
  • Joana Cruz Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.
  • Rafael Nascimento Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.
  • José Maurício Silva Unidade de Ortoprotesia, Centro de Medicina de Reabilitação do Alcoitão. Alcabideche, Portugal.
  • Maria Teresa Tomás Área Científica de Fisioterapia, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa. Lisboa, Portugal.

DOI:

https://doi.org/10.25758/set.424

Keywords:

O2 consumption (VO2), Mechanical prosthetic knee, Transfemural amputation, Energy expenditure, Gait efficiency

Abstract

Background – Prosthetic components have a crucial role in the energy efficiency of an amputee’s gait. This is an area of ​​knowledge still in development, where research plays a central role. Objective – The purpose of this case study is to compare the impact on energy consumption of two prosthetic knees, a titanium single-axis constant friction knee joint with internal extension assist, 3R34 (A), and a single-axis pneumatic swing phase control, 3R92 (B). Methodology – The participant was a transtibial amputee, male, with 27 years old, with no other clinical or functional impairments. To measure the energy expenditure a submaximal treadmill (H/P/Cosmos(R) Mercury) exercise stress test combined with a breath-by-breath analysis system (Cosmed Quark PFT Ergo) was used. The same test was applied to both knees, separated by two days. The analyzed variables were O2 consumption (VO2), metabolic equivalent (MET), and gait efficiency (VO2 ratio expected from a healthy individual and the studied individual). A rate of perceived exertion (Borg’s Scale) was used. Results – The results were favorable to knee A (24.2 ml O2/kg/min; 6.9 MET, 43% efficiency) compared with knee B (28.68 ml O2/kg/min; 8.2 MET, 39% efficiency). Conclusion – In this case, a less energy consumption gait corresponds to the prosthesis with knee A. These values may be influenced by the short adaptation period with knee B, so it’s necessary to perform more studies to confirm the previous results and to understand the true impact of the correct adaptation factor to the best prosthetics components for different patients.

Downloads

Download data is not yet available.

References

Bard G, Ralston HJ. Measurement of energy expediture during ambulation, with special reference to evaluation of assistive devices. Arch Phys Med Rehabil. 1959;40:415-20.

Waters RL, Perry J, Antonelli D, Hislop HJ. Energy cost of walking of amputees: the influence of level amputation. J Bone Joint Surg. 1976;58:42-6.

Nielsen DH, Shurr DG, Golden JC, Meier K. Comparison of energy cost and gait efficiency during ambulation in below-knee amputees using different prosthetic feet: a preliminary report. J Prosthet Orthot. 1988;1(1):24-31.

Mattes SJ, Martin PE, Royer TD. Walking symmetry and energy cost in persons with unilateral transtibial amputations: matching prosthetic and intact limb inertial properties. Arch Phys Med Rehabil. 2000;81(5):561-8.

Rietman JS, Postema K, Geertzen JH. Gait analysis in prosthetics: opinions, ideas and conclusions. Prosthet Orthot Int. 2002;26(1):50-7.

Bussmann JB, Schrauwen HJ, Stam HJ. Daily physical activity and heart rate response in people with a unilateral traumatic transtibial amputation. Arch Phys Med Rehabil. 2008;89(3):430-4.

Johansson JL, Sherrill DM, Riley PO, Bonato P, Herr H. A clinical comparison of variable-damping and mechanically passive prosthetic knee devices. Am J Phys Med Rehabil. 2005;84(8):563-75.

Hafner BJ, Willingham LL, Buell NC, Allyn KJ, Smith DG. Evaluation of function, performance and preference as transfemoral amputees transition from mechanical to microprocessor control of the prosthetic knee. Arch Phys Med Rehabil. 2007;88(2):207-17.

Kaufman KR, Levine JA, Brey RH, McCrady SK, Padgett DJ, Joyner MJ. Energy expenditure and activity of transfemoral amputees using mechanical and microprocessor-controlled prosthetic knees. Arch Phys Med Rehabil. 2008;89(7):1380-5.

Waters RL, Mulroy S. The energy expenditure of normal and pathologic gait. Gait Posture. 1999;9(3):207-31.

American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. 9th ed. Lippincott, Williams & Wilkins; 2010.

Fergason J. Prosthetic feet. In Lusardi MM, Nielsen CC, editors. Orthotics and prosthetics in reahabilitation. New York: Elsevier; 2007. p. 656.

Prosthetics Research Study. Prosthesis evaluation questionnaire. Seattle-WA: Author; 1998.

Gailey RS, Nash MS, Atchley TA, Zilmer RM, Moline-Little GR, Morris-Cresswell N, et al. The effects of prosthesis mass on metabolic cost of ambulation in non-vascular trans-tibial amputees. Prosthet Orthot Int. 1997;21(1):9-16.

Traballesi M, Porcacchia P, Averna T, Brunelli S. Energy cost of walking measurements in subjects with lower limb. Gait Posture. 2008;27(1):70-5.

McArdle WD, Katch FL, KatchVL. Fisiologia do exercício. 5ª ed. Rio de Janeiro: Guanabara Koogan; 2001. Portuguese

Waters RL. Gasto energético. In Análise de marcha: sistemas de análise de marcha. Barueri: Manole; 2005. p. 85-120. Portuguese

Published

2011-11-15

Issue

Section

Artigos

How to Cite

Gait energy consumption and gait efficiency with two different models of prosthetics knees: a single case report. (2011). Saúde & Tecnologia, 06, 38-43. https://doi.org/10.25758/set.424