Search

Objective: This study presents the walking abilities of participants fitted with transfemoral bone-anchored prostheses using a total of 14 gait parameters. Design: Two-centre retrospective cross-sectional comparative study. Setting: Research facilities equipped with tridimensional motion capture systems. Participants: Two control arms included eight able-bodied participants arm (54 ± 9 years, 1.75 ± 0.07 m, 76 ± 7 kg) and nine participants fitted with transfemoral socket-suspended prostheses arm (59 ± 9 years, 1.73 ± 0.07 m, 80 ± 16 kg). The intervention arm included nine participants fitted with transfemoral bone-anchored prostheses arm (51 ± 13 years, 1.78 ± 0.09 m, 87.3 ± 16.1 kg). Intervention: Fitting of transfemoral bone-anchored prostheses. Main measures: Comparisons were performed for two spatio-temporal, three spatial and nine temporal gait parameters. Results: The cadence and speed of walking were 107 ± 6 steps/min and 1.23 ± 0.19 m/s for the able-bodied participants arm, 88 ± 7 steps/min and 0.87 ± 0.17 m/s for the socket-suspended prosthesis arm, and 96 ± 6 steps/min and 1.03 ± 0.17 m/s for bone-anchored prosthesis arm, respectively. Able-bodied participants and bone-anchored prosthesis arms were comparable in age, height, and body mass index as well as cadence and speed of walking, but the able-bodied participant arm showed a swing phase 31% shorter. Bone-anchored and socket-suspended prostheses arms were comparable for age, height, mass, and body mass index as well as cadence and speed of walking, but the bone-anchored prosthesis arm showed a step width and duration of double support in seconds 65% and 41% shorter, respectively. Conclusions: Bone-anchored and socket-suspended prostheses restored equally well the gait parameters at a self-selected speed. This benchmark data provides new insights into the walking ability of individuals using transfemoral bionics bone-anchored prostheses. [ABSTRACT FROM AUTHOR] more...

The aim of this systematic review with meta-analysis was to determine the change in gait biomechanics after total ankle replacement and ankle arthrodesis for end-stage osteoarthritis. Electronic databases were searched up until May 2019. Peer-reviewed journal studies including adult participants suffering from end-stage ankle osteoarthritis and reporting pre- and post-operative kinematics, kinetics and spatio-temporal effects of total ankle replacement and ankle arthrodesis during walking were included with a minimum of 12 months follow-up. Seventeen suitable studies were identified and assessed according to methodological and biomechanical qualities. Meta-analysis was performed by calculating the effect size using standard mean differences between pre- and post-operative gait status. Seventeen studies with a total of 883 patients were included. Meta-analysis revealed moderate evidence of an improvement in lower limb kinematics, kinetics and spatio-temporal parameters after total ankle replacement. Moderate evidence indicated an increase in ankle moment, hip range of motion and walking speed after ankle arthrodesis. The currently available evidence base of research papers evaluating changes in gait biomechanics after total ankle replacement and ankle arthrodesis is limited by a lack of prospective research, low sample sizes and heterogeneity in the patho-etiology of ankle osteoarthritis. Following total ankle replacement, improvements were demonstrated for spatio-temporal, kinematic and kinetic gait patterns compared to the pre-operative measures. Improvements in gait mechanics after ankle arthrodesis were limited to walking speed and ankle moment. Increased hip range of motion after ankle arthrodesis could represent a sign of compensation for the lack of ankle motion. • Moderate evidence to suggest that lower extremity biomechanics improved after total ankle replacement. • Moderate evidence to suggest that total ankle replacement improves pre-operative ankle range of motion by 3°. • No difference in outcomes between fixed- versus mobile-bearing prosthesis • Ankle moment, hip range of motion and walking speed increased after ankle arthrodesis. [ABSTRACT FROM AUTHOR] more...

Introduction Coordination between shoulder and pelvis girdles during walking is pivotal to optimise a stable forward displacement (Lamoth and van Heuvelen, 2012). Hip osteoarthritis (HOA) increases the stiffness of the pelvis and the low back and should impair this coordination. To our knowledge, no study evaluates this outcome for HOA. The aim was to evaluate the psychometric properties of the pelvis-shoulder coordination in healthy (HEA) and non-severe unilateral HOA subjects. Material and methods HEA and HOA subjects were enrolled. Each participant performed a 3D gait analysis along a 6-metre walkway using an optoelectronic system with 8 cameras (100 Hz). HOA performed a second session to evaluate measurement's reliability (test-retest). Pelvis and shoulder yaws (transverse plane) and rolls (frontal plane) were calculated using markers positioned on the acromial process and the anterior-superior iliac spines. The phase-lag between angle waveforms expressed as a gait cycle's percentage was computed using continuous estimate of relative phase (CRP; Russell Esposito and Wilken, 2014). Intraclass correlation (ICC), one-way Anova and Pearson correlation coefficient were used to evaluate respectively, reliability, responsiveness and validity (against HOOS scores; Ornetti et al., 2009). Results Seventy-eight HEA (58.4 ± 15.4 years) and 103 HOA (61.0 ± 8.1 years) subjects were included. ICC were excellent for roll-lag (0.918) and yaw-lag (0.959). Significant difference was found for roll-lag between subjects (HEA 37.8 ± 10.6%; OA 29.5 ± 9.8%, P < 0.001), but not for yaw-lag. Moreover, roll-lag was correlated with clinical scores ( r > 0.24, P < 0.03 for HOOS pain/ADL/recreational and sports; r = −0.27, P = 0.013 for Lesquene index). Discussion–conclusion Pelvis-shoulder coordination outcomes showed excellent reliability. Roll-lag was related to clinical scores whereas yaw-lag did not. As only non-severe patients were included, these outcomes need to be addressed in population with higher impairment. It could be then proposed as an objective outcome to evaluate deficit in hip osteoarthritis patients. [ABSTRACT FROM AUTHOR] more...