Determining the Potential Benefit of Powered Prostheses
Abstract
Currently, there are 1.6 million people in the United States living with limb loss. With a prosthetic device, many of these individuals can remain physically active, but most do not achieve medically recommended physical activity standards and are therefore at a greater risk of cardiovascular disease. It is thought that individuals with amputation walk less because it is more metabolically costly for them to do so. Recent advances in robotic prosthetic technology may alleviate some of these metabolic costs. In particular, several active ankle-foot systems are being designed to provide external power during the push-off phase of gait. These devices have not yet been critically evaluated to determine their effectiveness during extended walking. Although the devices provide mechanical power, it is not clear whether the user effectively incorporates that power to reduce biological muscle requirements. We propose to evaluate the efficacy of a powered lower limb prosthesis by studying 12 individuals with unilateral below-knee (transtibial) amputation. The study is a cross-over design study of two prostheses. Participants will come to the laboratory for four separate visits. On the first day, they will be consented, screened to ensure eligibility in the study, and given a clinical evaluation of range of motion and strength. In this session, they undergo metabolic testing. On their next visit, participants will complete biomechanical gait analysis and fatigue testing. They will then be given an accelerometer and GPS device for 2 weeks of at-home monitoring in order to assess physical activity levels. Half of participants will complete this protocol first with a powered prosthesis (BiOM, Cambridge, MA) and then with their clinically prescribed prosthesis, while the other half will undergo testing with their clinically prescribed prosthesis first. Participants will complete questionnaires about satisfaction and quality of life at the end of each 2-week home monitoring period. Aim 1 will determine if adding external ankle power reduces compensatory muscle activity during walking. Aim 2 will determine if adding external ankle power delays the onset of muscle fatigue during an extended bout of walking. Aim 3 will determine if, by wearing an externally powered prosthesis, people will increase their overall physical activity level, reintegrate into their communities, and/or see improvement in their quality of life. The outcomes of this study will provide much needed insight into the effectiveness of such devices in people with transtibial amputation. The results will also help to make future recommendations for clinicians who choose which device to provide a patient, funding agencies, such as Medicare, who decide what devices are covered, and those who design prosthetic technology.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Apr 04, 2016
- Source ID
- W81XWH1510548
Entities
People
- Deanna H. Gates
Organizations
- United States Army
- University of Michigan