Intra-individual biomechanical effects of a non-microprocessor-controlled stance-yielding prosthetic knee during ramp descent in persons with unilateral transfemoral amputation

Yusuke Okita, Nobuya Yamasaki, Takashi Nakamura, Tomoki Mita, Tsutomu Kubo, Atsuko Mitsumoto, Toru Akune
Prosthetics and Orthotics International 2018 July 27, : 309364618789453

BACKGROUND: A stance-yielding mechanism for prosthetic knees may reduce lower limb loading during specific activities, but quantitative data are insufficient.

OBJECTIVES: To clarify the biomechanical effect of a non-microprocessor-controlled stance-yielding mechanism on ramp descent for individuals with unilateral transfemoral amputation.

STUDY DESIGN: Intra-subject intervention study.

METHODS: Seven individuals with unilateral transfemoral amputation underwent three-dimensional motion analysis of ramp descent with and without activating a stance-yielding mechanism. Regarding early-stance internal joint moment and ground reaction force, whole-group and subgroup analyses stratified by stance prosthetic knee flexion were performed to verify differences in prosthetic side and contralateral limb loading between conditions.

RESULTS: Whole-group analysis revealed significant reduction in early-stance prosthetic knee extension moment with stance-yielding mechanism activation. Changes in prosthetic side hip extension moment and contralateral limb loading were inconsistent between conditions. Subjects with prosthetic stance knee flexion walked slower with a smaller stride and greater increase in aft ground reaction force and ankle dorsiflexion moment when stance-yielding was activated.

CONCLUSION: Stance-yielding mechanism has a biomechanical potential to decrease excessive knee hyperextension. However, prosthetic side stance knee flexion induced by the stance-yielding mechanism might not necessarily reduce the mechanical load on residual hip or contralateral lower limb joints. Clinical relevance This study showed individual variability in the possibility of reducing the load on the remaining lower limb when using a non-microprocessor-controlled stance-yielding knee. This suggests that individualized prosthetic management and monitoring the activities of individuals wearing a stance-yielding prosthetic knee are crucial to maximize the benefits of stance-yielding prosthetic knees.


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