Determining the Potential Benefit of Powered Prostheses
Technical Report,30 Sep 2015,29 Sep 2016
Regents of the University of Michigan Ann Arbor United States
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Background While the World Health Organization advises people with disabilities to exercise regularly and walk as much as able-bodied individuals, people with transtibial amputation are less likely to get the suggested amount of physical exercise and correspondingly are at a greater risk of death from cardiovascular disease Modan et al. 1998. Their reduced activity may be attributed to the 10 - 30 increase in energetic cost during walking for people with transtibial amputations compared to able-bodied individuals Torburn et al. 1995, Hsu et al. 2006. New, powered, ankle prostheses have shown promise at decreasing the metabolic cost of walking Herr and Grabowski 2012 and normalizing ankle kinematics and kinetics Ferris et al. 2012 in a few, high functioning patients. However, it is unclear what reduction in muscular effort prompts this decreased cost, whether the results would extend to patients who are not as high functioning, or whether decreased metabolic costs translate to positive changes in behavior i.e. increase activity level. Additionally, very little is known about how people with transtibial amputations fatigue on an individual muscle level, so decreased metabolic costs may not translate into an ability to walk for longer durations. It is critical to address these knowledge gaps to determine if the benefits warrant the nearly threefold increase in price and advise whether researchers should continue to improve or alter current powered prostheses or whether insurance companies should reimburse for them. This project is in direct support of F14 OPORAs focus area of examining the long-term functional and patient centered outcomes associated with the effect of different orthotic andor prosthetic devices on achievement of maximal functional ability.
- Medicine and Medical Research
- Anatomy and Physiology