Smith, Jeremy D.
In this dissertation, a model was developed to predict the inertial properties of the shank and foot of persons with TTA and functional differences between Ertl and Burgess amputees during curb negotiation and the sit-to-stand tasks were evaluated. The developed inertial model was able to predict the shank and foot segment mass, COM location, and MOI more accurately than using the intact limb inertial properties. Used as inputs into inverse dynamics equations, the general model predictions produced joint moments which were also similar to the subject-specific measures. Thus, this model is a better predictor than the current method of using the intact limb inertial measures for the amputated limb. The second and third studies showed differences between the Ertl and Burgess amputated limbs in functional ability. During curb negotiation the Ertl amputated limb produced net limb work (sum of ankle, knee, and hip work) similar to that of the intact limbs of both groups on the curb step. This net limb work was produced by the hip early in stance phase as a compensatory mechanism to help propel the body forward. During the sit-to-stand task, the Ertl group was able to perform the task more quickly than the Burgess group. The faster performance time was due in part to larger ground reaction forces in the Ertl amputated limb compared to the Burgess amputated limb. This suggested the Ertl limb was able to bear higher loads overall during this task. While no other differences were found between the amputated limbs, the Ertl intact limb showed unexpected differences. Where the Burgess limbs and Ertl amputated limb adopted a hip strategy to complete the task, the Ertl intact limb adopted a knee strategy. This knee strategy is more similar to the way non-amputees complete the task. Both study 2 and 3 highlighted functional advantages of the Ertl procedure over the Burgess procedure for these tasks and is, to our knowledge, the first study of its kind. Based on these outcomes, it appears that the Ertl procedure does lead to better functional performance during prosthesis use, and further consideration should be given to using this procedure at the time of amputation. Future work needs to continue to focus on functional performance in both groups and begin to contrast the outcomes with post-operative risks following the amputation to better inform patients and clinicians about potential advantages of either technique.
Amputee, Curb, Ertl, Inertial properties, Sit to stand
Copyright is held by the author.
Ferris, Abbie Elthea, "Biomechanical Assessment of Ertl and Burgess Transtibial Amputation Techniques" (2016). Dissertations. 301.