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.