Journal of Rehabilitation Research & Development (JRRD)

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Volume 50 Number 5, 2013
   Pages 671 — 686

Abstract — Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle

Shane R. Wurdeman, CP, MSPO;1–2 Sara A. Myers, PhD;1 Adam L. Jacobsen, CPO;3 Nicholas Stergiou, PhD1–2*

1Nebraska Biomechanics Core Facility, University of Nebraska at Omaha, Omaha, NE; 2College of Public Health, University of Nebraska Medical Center, Omaha, NE; 3Department of Prosthetics and Sensory Aids, Department of Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE

Abstract — The purpose of this study was to determine the relationship between stride-to-stride fluctuations and prosthesis preference. Thirteen individuals with unilateral, transtibial amputation consented to participate. Individuals walked on a treadmill for 3 min with their prescribed and an alternate prosthesis. Stride-to-stride fluctuations were quantified with the largest Lyapunov exponent (LyE) of each joint flexion/extension time series. The change in the LyE was calculated for each major lower-limb joint for both conditions. Participants indicated preference between the prostheses on a continuous visual analog scale. The change in the LyE was correlated with the degree of preference between the two prostheses at the prosthetic ankle. The change in the LyE of the prosthetic ankle was strongly related to the degree of preference (r = 0.629, p = 0.02). Thus, stride-to-stride fluctuations, quantified by the LyE, are strongly related to the patient's perception of the prosthesis. As a result, the LyE is the first objective measure to detect changes in gait that relate to the patient's perception of the prosthesis. The LyE should be further examined as a potentially effective prescriptive and outcome measure in prosthetic rehabilitation.

Key words: amputation, dynamic stability, dynamical system, gait, limb loss, Lyapunov exponent, nonlinear dynamics, outcomes, perception, rehabilitation, transtibial, variability.


View HTML  ¦  View PDF  ¦  Contents Vol. 50, No. 5
This article and any supplemental material should be cited as follows:
Wurdeman SR, Myers SA, Jacobsen AL, Stergiou N. Prosthesis preference is related to stride-to-stride fluctuations at the prosthetic ankle. J Rehabil Res Dev. 2013; 50(5):671–86.
http://dx.doi.org/10.1682/JRRD.2012.06.0104
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