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14: Analysis of Amputee Gait | O&P Virtual Library

• Terminal swing impact

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Analysis of Amputee Gait Norman Berger, M.S

To achieve knee stability in stance phase by resisting knee flexion during weight bearing

(Andrysek, Klejman, Torres-Moreno, Heim, Sreinnagel et al., 2011)
(Michael, 1999)
Five levels are available;
Voluntary Vs Stability
is observed through the mechanical properties of the prosthetic knee
i.e the amount of friction that is present to prevent instability
Weight Activated Stance Control Knee
'Safety Knee'
Single axis - constant friction
Has a breaking mechanism
When weight is put on knee during gait, the knee is locked in extension
When weight is unloaded, the knee is then free to bend for swing phase
Commonly used
(Artisan, 2013; Dupes, 2008; Mauch, H.,1999; Michael, J., 1999; Schaffer, Kort, Kreuter, 2008)
(Michael, 1999)
Two important factors in stance control

Controlled knee flexion in weight bearing
Gradual extension under load
Knee considered stable because of extension moment produced when the GRF is anterior to the center of joint.

Hip Disarticulation Specialist Tony van der Waarde | Award Prosthetics
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Case Study 3
The knee will not buckle under wight force, it will be kept in full knee extension
Very stable knee
Can eliminate gait deviations associated with stiff legged gait
Missteps can be corrected
Simple design
Low cost
Most durable
Lightest option available
Knee flexion only occurs if weight is fully removed from the prosthesis
Delayed initiation of swing phase
Walking at a faster pace disrupts/ changes the break stability and can interfere with knee flexion during pre-swing
Requires good muscular power for voluntary stability control
Appropriate for elderly clients
Clients with slow walking pace
Less active clients
Can and is commonly used for a first trasnfemoral prosthesis

18B: Prosthetic Management | O&P Virtual Library

Online Press Release Distribution Service | PRWeb
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The friction-brake stance control (safety) knee is probably the second most frequently utilized component. Because there is very little increase in cost or weight and reliability has been good, many clinicians feel that the enhanced knee stability justifies this approach, particularly for the novice amputee. Missteps causing up to 15 degrees of knee flexion will not result in knee buckle, which makes gait training less difficult for the patient and therapist. The major drawback to this knee is that the limb must be non-weight bearing for knee flexion to occur. Although this generally presents no problem during swing phase, some patients have difficulty in mastering the weight shift necessary for sitting. It should be noted that use of such knee mechanisms bilaterally must be avoided. Since it is impossible for the amputee to simultaneously unload both artificial limbs, sitting with two stance control knees becomes nearly impossible.

The accuracy of data derived from linked-segment models depends on how well the system has been represented. Previous investigations describing the gait of persons with partial foot amputation did not account for the unique anthropometry of the residuum or the inclusion of a prosthesis and footwear in the model and, as such, are likely to have underestimated the magnitude of the peak joint moments and powers. This investigation determined the effect of inaccuracies in the anthropometric input data on the kinetics of gait. Toward this end, a geometric model was developed and validated to estimate body segment parameters of various intact and partial feet. These data were then incorporated into customized linked-segment models, and the kinetic data were compared with that obtained from conventional models. Results indicate that accurate modeling increased the magnitude of the peak hip and knee joint moments and powers during terminal swing. Conventional inverse dynamic models are sufficiently accurate for research questions relating to stance phase. More accurate models that account for the anthropometry of the residuum, prosthesis, and footwear better reflect the work of the hip extensors and knee flexors to decelerate the limb during terminal swing phase.

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