PROPER EVALUATIONS AND SUGGESTIONS OF EQUIPMENT FOR SERVICEMEMBERS WITH LOWER LIMB AMPUTATIONS ATTEMPTING TO RETURN TO PHYSICAL ACTIVITES
Toney, CM: Norwich University, Northfield, Vermont
Returning to Active Duty
Redeployed or taking on physically demanding occupations
You may be wondering, how is this possible?
According to John Fergason, chief of prosthetics at the Army
Center for the Intrepid at Fort Sam in Houston, Texas, “When we have someone we know wants to return, their rehab is geared that
way.”
Fergason and his colleague, Ryan Blanck, say that each branch of the military
has its own guidelines for allowing an amputated soldier to return to work,
depending on his or her task. In many cases, it takes at least a year for a
soldier to return to duty. The requirements for a fighter pilot, for instance, will
be different than those for an infantryman or a behind-the-scenes supplies
manager.
But Fergason says that the soldiers who are going back into battle are able to
perform just as well, if not better, than some of their fellow soldiers.
Research Focus Balance ability and its relation to mobility
Factors related to high-level mobility in service members
Effects of gait with prosthetic Ankle Motions
Effects of walking speed and prosthetic ankle adapters on upper extremity dynamics
Assessment of gait stability in lower-limb amputees
Effect of running speed and leg prostheses on Medio lateral foot placement
Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss
MEASUREMENTSI. Self-reported prosthetic use for mobility
a. Duration of daily prosthesis wear
b. Use of prosthesis and assistive device
c. Perceived stability when using the prosthesis for mobility on terrains
II. Balance confidence using ABC
a. 16 tasks
III. Performance-based balance ability
a. BBS
b. 14 tasks that challenge static and dynamic balance
RESULTS
Factors related to high-level mobility in male service members with traumatic lower-limb loss
METHODSI. High-Level Mobility – CHAMP score
a. Single Limb Stance (SLS)
b. Edgren Side Step Test (ESST)
c. T-Test
d. Illinois Agility Test (IAT)
RESULTS
The effects of increased prosthetic ankle motions on the gait of persons with bilateral transtibial amputations
METHODS I. 1) Seattle Lightfoot II 2) Seattle Lightfoot II w/ Endolite Multiflex
Ankles/Otto Bock Torsion Adapters 3) Endolite Multiflex Ankles w/ Otto Bock Torsion Adapters
II. Data Collection and Analyses using eight-camera motion capture system and embedded flush with the floor used for ground reaction forces
III. 5-point Likert scale used for subjective perceptions
Gait Analysis
https://www.youtube.com/watch?v=BcGDu22xtZ4
RESULTS
The effects of walking speed on prosthetic ankle adapters on upper extremity dynamics and stability-related parameters in bilateral transtibial amputee gait
METHODSI. Overground walking trials along a ten meter level walkway
II. PC1)Seattle Lightfoot II foot, Multiflex Ankle PC2)Seattle Lightfoot II, Multiflex Ankle, and Torsion Adapter
III. Digital motion capture system
IV. T-test
RESULTS
Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations
METHODSI. Before dismissal from hospital subjects performed:
a. 10 m walking test
b. Stood on a line and walked straight for 10 m at a self-selected speed
c. Then arrived at a 15 m long rehabilitation gym
RESULTS
Effect of running speed and leg prostheses on Medio lateral foot placement and its variability
METHODSI. Measured midline of the body and center of pressure in the ML
direction
II. Running speeds ranged up to maximum on a treadmill
III. Data was compared between non-amputees, UTAs, and BTAs
RESULTS
Sprinters running at different speeds
Non-Amputee
Vs
Unilateral Transtibial Amputee
Vs
Bilateral Transtibial Amputee
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295868/
Conclusion
Meta-Analysis was performed to increase knowledge and understanding on prosthetics and to research what works better for these amputees. This should be used to inform us as clinicians as to what we need to focus on with our amputee patients and what to not overlook throughout the rehabilitation process.
References Arellano, C., McDermott, W., Kram, R., and Grabowski, A. Effect of running speed and leg prostheses and
mediolateral foot placement and its variability. 2015; 10(1): e0115637. doi:10.1371/journal.pone.0115637.
Gaunard, I., Roach, K., Raya, M., Hooper, R., Linberg, A., Laferrier, J., et. al. Factors related to highlevel mobility in male servicemembers with traumatic lower-limb loss. Journal of Rehabilitation &Development. 2013; 50(7): 969-984. http://www.rehab.research.va.gov/jour/2013/507/page969.html
Iosa, M., Paradisi, F., Brunelli, S., Delussu, A., Pellegrini, R., Zenardi, D., et. al. Assessment of gaitstability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations. Journal of Rehabilitation Research & Development. 2014; 51(4): 623-634.http://www.rehab.research.va.gov/jour/2014/514/page623.html
Major, M., Stine, R., and Gard, S. The effects of walking speed and prosthetic ankle adapters on upperextremity dynamics and stability-related parameters in bilateral transtibial amputee gait. 2013; 38(4): 858-863. doi: 10.1016/j.gaitpost.2013.04.012.
Su, P., Gard, S., Lipschutz, R., and Kuiken, T. The effects of increased prosthetic ankle motions on thegait of persons with bilateral transtibial amputations. Am J Phys Med Rehabil. 2010; 89(1): 34-47. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805409/
Wong, C., Chen, C., Benoy, S., Rahal, R., and Blackwell, W. Role of balance ability and confidence inprosthetic use for mobility of people with lower-limb loss. Journal of Rehabilitation Research & Development. 2014; 51(9): 1353-1364. http://www.rehab.research.va.gov/jour/2014/519/JRR-2013-11-0235.html
New Prosthetics Keep Amputee Soldiers on Active Duty. U.S. News Web site. http://www.usnews.com/news/articles/2012/05/25/new-prosthetics-keep-amputee-soldiers-on-activeduty
Published May 25, 2012. Accessed April 26, 2015.