|dc.description.abstract||The AIMS of the thesis were to critically evaluate motion analysis methods
used during investigations of transtibial prosthesis users, and to propose
improvements to these methods. Additionally, the aim was to evaluate if
vibratory feedback could be used to improve postural stability in transtibial
prosthesis users and how being a prosthesis user influenced muscular
response to postural perturbations.
MATERIALS AND METHOD Study I systematically analyzed 68 peerreviewed
articles investigating lower-limb kinematics in transtibial prosthesis
users. Study II evaluated motion of prosthetic feet using a functional joint
centre (FJC) method. Study III evaluated the influence of a vibratory
feedback device on postural stability in 24 transtibial prosthesis users. Study
IV investigated how the prosthetic limb affected EMG response latency in the
prosthetic- and intact-limb of 23 transtibial prosthesis users when compared
to a matched able-bodied control group (n=23).
RESULTS Study I showed a general low level of evidence and low quality in
the studies under review and that there were methodological problems which
made comparison of studies difficult. Study II found that sagittal position of
FJCs for prosthetic feet were different between types of prosthetic feet as
well as compared to an intact ankle. Study III showed vibratory feedback
based on pressure under the prosthetic foot caused increased deviations of the
centre of pressure in the mediolateral direction, and decreased reaction times
in fast voluntary movements of the centre of gravity. Study IV showed the
EMG response latencies of transtibial prosthesis users were increased in both
the intact limb and the prosthetic limb. Increased latencies were found in the
contralateral limb when the perturbation was received through the prosthesis.
CONCLUSIONS Methodological issues make interpretation of kinematics
of transtibial prosthetic users difficult and motion of the prosthetic foot is not
the same in different designs of prosthetic feet or compared to an intact limb.
Vibratory feedback can be used to improve some aspects of postural stability,
and automatic postural responses are slower in transtibial prosthesis users
than in able-bodied controls. These findings contribute to the understanding
of how researchers model motion of transtibial prosthesis users and how this
group maintains postural stability with a prosthesis.||sv
|dc.relation.haspart||I. Rusaw D., Ramstrand N.
Motion-analysis studies of transtibial prosthesis-users: a systematic review.
Prosthetics and Orthotics International 2011, 35(1), 8-19. ::DOI::10.1177/0309364610393060||sv
|dc.relation.haspart||II. Rusaw D., Ramstrand N.
Sagittal plane position of the functional joint centre of prosthetic footankle mechanisms.
Clinical Biomechanics, 2010, 25(7), 713-720. ::DOI::10.1016/j.clinbiomech.2010.04.005||sv
|dc.relation.haspart||III. Rusaw D., Hagberg K., Nolan L., Ramstrand N.
Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?
|dc.relation.haspart||IV. Rusaw D., Hagberg K., Nolan L., Ramstrand N.
The contribution of the prosthesis and weight bearing on EMG response latency following platform perturbation in transtibial prosthesis users.
|dc.title||Motion Analysis and Postural Stability of Transtibial Prosthesis Users||sv
|dc.type.degree||Doctor of Philosophy (Medicine)||sv
|dc.gup.origin||University of Gothenburg. Sahlgrenska Academy||sv
|dc.gup.department||Institute of Clincial Sciences. Department of Orthopaedics||sv
|dc.gup.defenceplace||Fredagen den 25 november 2011, kl. 13.00, Hörsal Arvid Carlsson, Academicum, Medicinaregatan 3, Göteborg||sv