Energy expenditure and gait characteristics of a bilateral amputee walking with C-leg prostheses compared with stubby and conventional articulating prostheses

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Energy expenditure and gait characteristics of a bilateral amputee walking with C-leg prostheses compared with stubby and conventional articulating prostheses Jacquelin Perry, MD, Judith M. Burnfield, PhD, PT, Craig J. Newsam, DPT, Phil Conley, CP Archives of Physical Medicine and Rehabilitation Volume 85, Issue 10, Pages 1711-1717 (October 2004) DOI: 10.1016/j.apmr.2004.02.028 Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 (A) Note the patient’s stride length when walking on level surfaces with bilateral C-Leg prostheses. (B) The large arc of prosthetic knee flexion allows for toe clearance during initial swing. Hip flexion is minimal. Archives of Physical Medicine and Rehabilitation 2004 85, 1711-1717DOI: (10.1016/j.apmr.2004.02.028) Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 Joint motions of right lower extremity. (A) Hip range is the sum of (B) the thigh and (D) pelvis motion. Note the prolonged thigh extension arc until 56% of the gait cycle. (C) Knee shows sustained 5° of flexion and lacks loading response flexion wave. (E) Ankle shows significantly reduced preswing plantarflexion. Black line represents subject’s data; gray area is normative data (±1 standard deviation [SD]). Archives of Physical Medicine and Rehabilitation 2004 85, 1711-1717DOI: (10.1016/j.apmr.2004.02.028) Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 Sagittal plane lower-extremity external joint moments. (A) Hip: a normative moment pattern sequence was displayed, however, the peaks in weight acceptance and terminal stance were diminished. (B) Knee: lacks a significant peak in loading response and preswing. (C) Ankle: preswing loading response peak is missing. Black line represents subject’s data; gray area is normative data (±1 SD). Archives of Physical Medicine and Rehabilitation 2004 85, 1711-1717DOI: (10.1016/j.apmr.2004.02.028) Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 Lower-extremity sagittal plane powers. (A) Hip: initial contact peak power generation is greater than the normative power generation. Subsequent peaks during stance are subdued. (B) Ankle: terminal stance absorption pattern is present. Preswing generation peak is absent. Black line represents subject’s data; gray area is normative data (±1 SD). Archives of Physical Medicine and Rehabilitation 2004 85, 1711-1717DOI: (10.1016/j.apmr.2004.02.028) Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 (A) The pattern of COP progression closely followed the normative pattern. (B) Consistent with the patient’s slowed velocity (71% N), the normative peaks in vertical ground reaction force were absent. Black line represents subject’s data; gray area is normative data (±1 SD). Archives of Physical Medicine and Rehabilitation 2004 85, 1711-1717DOI: (10.1016/j.apmr.2004.02.028) Copyright © 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions