Vacuum level effects on gait characteristics for unilateral transtibial amputees with elevated vacuum suspension |
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| Institution: | 1. School of Medical Imaging, Xuzhou Medical University, Xuzhou, China;2. Department of Mechanical Engineering, University of Utah, Salt Lake City, UT, USA;3. Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan;1. Department of Surgery, Faculty of Medicine, University of Montreal, C.P. 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7;2. Department of Surgery, CHU Sainte-Justine, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada H3T 1C4;3. Department of Surgery, Hôpital du Sacré-Coeur de Montréal, 5400 Boul Gouin O, Montréal, Québec, Canada H4J 1C5;1. Biomechanics Research Building, University of Nebraska at Omaha, 6160 University Drive, Omaha, NE 68182-0860, USA;2. College of Public Health, 984355 University of Nebraska Medical Center, Omaha, NE 68198-4355, USA;3. Hanger Clinics dba Advanced Prosthetics Center, 9109 Blondo St, Omaha, NE 68134, USA;1. Michigan State University Mechanical Engineering, 428 S. Shaw Lane, East Lansing, MI 48824, United States;2. Department of Mechanical Engineering, Michigan State University, 428 S. Shaw Lane, East Lansing, MI 48824, United States |
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| Abstract: | BackgroundThe elevated vacuum suspension system has demonstrated unique health benefits for amputees, but the effect of vacuum pressure values on gait characteristics is still unclear. The purpose of this study was to investigate the effects of elevated vacuum levels on temporal parameters, kinematics and kinetics for unilateral transtibial amputees.MethodsThree-dimensional gait analysis was conducted in 9 unilateral transtibial amputees walking at a controlled speed with five vacuum levels ranging from 0 to 20 in Hg, and also in 9 able-bodied subjects walking at self-preferred speed. Repeated ANOVA and Dunnett's t-test were performed to determine the effect of vacuum level and limb for within subject and between groups.FindingsThe effect of vacuum level significantly affected peak hip external rotation and external knee adduction moment. Maximum braking and propulsive ground reaction forces generally increased for the residual limb and decreased for the intact limb with increasing vacuum. Additionally, the intact limb experienced an increased loading due to gait asymmetry for several variables.InterpretationThere was no systematic vacuum level effect on gait. Higher vacuum levels, such as 15 and 20 in Hg, were more comfortable and provided some relief to the intact limb, but may also increase the risk of osteoarthritis of the residual limb due to the increased peak external hip and knee adduction moments. Very low vacuum should be avoided because of the negative effects on gait symmetry. A moderate vacuum level at 15 in Hg is suggested for unilateral transtibial amputees with elevated vacuum suspension. |
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