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Oscillation and Reaction Board Techniques for Estimating Inertial Properties of a Below-knee Prosthesis

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Does intact limb loading differ in servicemembers with traumatic lower limb loss?

Alison L Pruziner¹, Kathryn M Werner, Timothy J Copple

¹Department of Rehabilitation, Walter Reed National Military Medical Center, America Building (19), Room B315, 8901 Rockville Pike, Bethesda, MD, 20889, USA, alison.l.pruziner.civ@mail.mil.

Clinical Orthopaedics and Related Research

|May 17, 2014

Summary

Service members with traumatic lower limb loss experience increased intact limb loading, particularly those with transfemoral loss, suggesting a higher risk for arthritis. Interventions should address gait mechanics to mitigate this risk.

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Area of Science:

Biomechanics
Orthopedics
Rehabilitation Science

Background:

Knee and hip arthritis are linked to limb loading during walking.
Unilateral lower limb loss can alter gait, increasing forces on the intact limb.
The impact of traumatic limb loss and prosthesis use duration on these forces is not well understood.

Purpose of the Study:

To compare joint and limb loading in the intact limb of service members with and without unilateral lower limb loss.
To examine differences in intact limb loading based on prosthesis use duration (≤ 6 months vs. ≥ 2 years).

Main Methods:

Retrospective review of gait evaluations from 2008-2012 at military medical centers.
Included 32 unilateral transtibial, 49 unilateral transfemoral, and 28 control (no limb loss) participants.
Participants with limb loss were categorized by prosthesis use duration.

Main Results:

Higher intact limb loading rates and impulses were observed in individuals with transtibial loss early in rehabilitation (≤ 6 months) compared to controls.
Individuals with transfemoral loss showed elevated intact limb loading rates and impulses at both early (≤ 6 months) and late (≥ 2 years) stages of prosthesis use compared to controls.
No significant differences in limb loading were found between shorter and longer prosthesis use durations within the transtibial or transfemoral groups.

Conclusions:

Elevated intact limb loading is present early in rehabilitation for transtibial loss and persists throughout the process for transfemoral loss.
These findings indicate an increased risk of early-onset arthritis in the intact limb, especially for those with transfemoral limb loss.
Interventions targeting modifiable gait mechanics are crucial for mitigating arthritis development and progression in this population.