A 3D mathematical model to predict spinal joint and hip joint force for trans-tibial amputees with different SACH foot pylon adjustments

• Published in: Gait & posture Vol. 40; no. 4; pp. 545 - 548
• Main Authors: Yu, Chung-huang, Hung, Yu-Cheng, Lin, Yang-Hua, Chen, Guan-Xun, Wei, Shun-Hwa, Huang, Chang-Hung, Chen, Chen-Sheng
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.09.2014
• Subjects: Amputees - rehabilitation; Artificial Limbs; Biomechanical Phenomena; Female; Gait - physiology; Gait analysis; Hip Joint - physiology; Humans; Leg - surgery; Low back force; Male; Mathematic model; Middle Aged; Models, Statistical; Orthopedics; Predictive Value of Tests; Prosthesis Design; SACH foot; Spine - physiology; Tibia - surgery; Trans-tibial amputee; Mathematic model; SACH foot; Low back force; Gait analysis; Trans-tibial amputee
• ISSN: 0966-6362; 1879-2219; 1879-2219
• DOI: 10.1016/j.gaitpost.2014.06.013

•In SACH foot, the intact limb received a greater HJF than the prosthetic limb.•Shortening the SACH foot pylon by 1% can get lower LBF and HJF symmetry.•Shortening excessive length of the pylon in a prosthesis would increase the HJF and LBF. A solid-ankle cushioned heel (SACH) foot is a non-joint foot without natural ankle function. Trans-tibial amputees may occur toe scuffing in the late swing phase due to a lack of active dorsiflexion. To address this problem, clinical guidelines suggests shortening the pylon to produce a smooth gait. However, this causes a leg length discrepancy, induces asymmetry in the hip joint, and causes an overload of L5/S1 joint force. Therefore, this study aimed to investigate the influence of different prosthesis pylons on the hip joint and L5/S1 joint forces. Ten subjects were recruited using leg length for normalisation. Four different pylon reductions (0%, 1%, 2%, and 3%) were used for gait analysis. A Vicon system and force plates were used to collect kinematic data and ground reaction force, respectively. The software package MATLAB was used to create a mathematical model for evaluating the symmetry and force of the hip joint and the low back force of the L5/S1 joint. The model was validated by the correlation coefficient (CC=0.947) and root mean square (RMS=0.028 BW). The model estimated that the 1% group had a symmetrical hip joint force and a lower L5/S1 joint force in the vertical direction. This study indicates that a 1% pylon shortening on a SACH prosthesis is appropriate for a trans-tibial amputee.