Muscle and joint functions during walking in individuals with transfermoral amputation

Abstract

Individuals with unilateral transfemoral amputation depend on compensatory muscle and joint function to generate motion of the lower limbs, which can produce gait asymmetry. Osseointegration is an alternative technique to socket-based prostheses that is used for reducing socket-skin contact problems. However, between-limb differences in joint kinematics and net joint moments may lead to abnormal hip joint contact behavior and muscle function. The aim of this dissertation is to investigate gait compensatory mechanism in individuals with transfemoral amputations fitted with socket (TFA) and bone-anchored prostheses using osseointegrated implants (BAP). In this study, two experimental and computational approaches were used to quantify the contributions of the intact and residual limb’s contralateral muscles to body center of mass acceleration and hip joint contact forces during walking. In the first approach, kinematics and kinetics data were collected from 6 TFAs and 4 BAPs performing over-ground self-selected walking task. In the second approach, a processing framework was employed using OpenSim software and MATLAB API scripting for developing three-dimensional musculoskeletal models and then to predict muscle forces and muscle contribution to waling and hip joint reaction forces. It was found that the intact limb hip muscles contributed more to body center of mass acceleration and hip contact forces than those in the residual limb. The results also suggest that osseointegrated amputees could quantify to decrease the asymmetries in the biomechanical measures between the intact and residual limbs than socket-based prosthesis amputees. The findings of this study would be useful in developing rehabilitation training programs and design of prostheses to improve gait symmetry and mitigate post-operative musculoskeletal pathology.