Simulated gait training improves joint loading symmetry in unilateral transfemoral bone-anchored limb users

Área de la Ciencia:

• Biomechanics
• Rehabilitation Engineering
• Prosthetics

Sus antecedentes:

• Socket-related pathologies are common in transfemoral amputees.
• Bone-anchored limbs (BALs) are a promising alternative, but gait and joint loading asymmetries persist post-implantation.
• Current gait training focuses on symmetry, but its feasibility in BAL users is unknown.

Objetivo del estudio:

• To determine if gait symmetry is achievable for transfemoral BAL users.
• To investigate the biomechanical effects of enforcing gait symmetry using optimal control and musculoskeletal modeling.
• To assess changes in movement and joint loading symmetry after simulated gait training.

Principales métodos:

• Utilized OpenSim Moco for musculoskeletal modeling and optimal control simulations.
• Simulated gait training interventions for 11 transfemoral BAL users.
• Predicted target gait patterns and tracked them using subject-specific BAL models, evaluating symmetry metrics and joint loading.

Principales resultados:

• Simulated training resulted in more in-phase and correlated kinematic patterns between limbs.
• Achieved improved gait symmetry, demonstrating the clinical objective's feasibility.
• Increased amputated limb hip joint reaction forces and joint loading impulses, enhancing joint loading symmetry without adverse effects on the intact limb.

Conclusiones:

• Movement symmetry is achievable for transfemoral BAL users.
• Simulated gait training can improve both movement and joint loading symmetry.
• BAL users can achieve symmetrical gait without deleterious joint loading effects.