An investigation into the relationship between knee axis alignment and swing phase whip during trans-femoral amputee gait

Qa'dan, WN

Abstract

Lateral whip, which is defined as sideward motion of the prosthetic heel away from the
line of progression during swing phase of gait, is one of the common gait deviations that
trans-femoral amputees exhibit during walking. It poses several negative gait
characteristics to trans-femoral amputees. Changing the prosthetic knee axis alignment
in the coronal and transverse plane so that it is adducted (moved downwards medially)
and / or externally rotated (moved backwards laterally) is hypothesised to reduce lateral
whip. This thesis tests and discusses this hypothesis and the effects of changing
prosthetic knee axis alignment on the general gait pattern of trans-femoral amputees.
One trans-femoral amputee who had his limb amputated due to chondro-fibro sarcoma
participated in the current study. Infra-red camera system and force plates were used to
collect kinematic and kinetic data of the gait of the amputee participant under four
different alignment conditions. The effects of changing prosthetic knee axis alignment
in the coronal and transverse plane on lateral whip gait deviation in particular and on the
gait pattern in general, were analysed. The four alignment conditions are:
A) Standard - 00° adduction - 05°external rotation
B) Adduction - 20° adduction 05° external rotation
C) Rotation - 00° adduction - 10° external rotation
D) Adduction & Rotation - 20° adduction 10° external rotation
Walking trials under each alignment condition were first analysed using Qualisys Track
Manager (QTM, Qualisys Sweden). Data filtering and gait parameters calculation were
obtained using Visual 3D software (C-motion, USA). The data were then statistically
processed using SPSS (SPSS Inc, USA).
It was found that conditions (B, C and D) resulted in a significant reduction in lateral
whip, with condition (C) resulting in the largest reduction. The reduction in lateral whip
is most likely to be the result of significantly increased external rotation (reduction of
internal rotation) of prosthetic side hip joint that occurred in swing in conditions (B, C
and D). Conditions (B and D) however, caused maximum knee flexion during swing to
be significantly less than in conditions A and C. Another finding was that the pelvis of the amputee subject is significantly more anteriorly rotated than in condition A.

• Thesis Type: Dissertation
• Deposit Date: Aug 19, 2021
• Additional Information: Funders : University of Jordan
• Award Date: Jun 1, 2010