Transhumeral prosthesis use and disuse affects whole-body angular momentum

Julia A Dunn; Nicholas G Gomez; Bob Wong; Sarina K Sinclair; K Bo Foreman; Kent N Bachus; Heath B Henninger

doi:10.1016/j.clinbiomech.2024.106365

Transhumeral prosthesis use and disuse affects whole-body angular momentum

Clin Biomech (Bristol, Avon). 2024 Oct 18:120:106365. doi: 10.1016/j.clinbiomech.2024.106365. Online ahead of print.

Authors

Julia A Dunn¹, Nicholas G Gomez², Bob Wong³, Sarina K Sinclair⁴, K Bo Foreman⁵, Kent N Bachus⁶, Heath B Henninger⁷

Affiliations

¹ Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA. Electronic address: [email protected].
² Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; College of Health, Human Services & Nursing, California State University, 1000 E. Victoria Street, Carson, CA 90747, USA. Electronic address: [email protected].
³ College of Nursing, University of Utah, 10 2000 E, Salt Lake City, UT 84112, USA. Electronic address: [email protected].
⁴ Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, Utah 84148, USA. Electronic address: [email protected].
⁵ Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Physical Therapy and Athletic Training, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: [email protected].
⁶ Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Veterans Affairs, 500 Foothill Boulevard, Salt Lake City, Utah 84148, USA. Electronic address: [email protected].
⁷ Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA; Department of Biomedical Engineering, University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA. Electronic address: [email protected].

PMID: 39454313
DOI: 10.1016/j.clinbiomech.2024.106365

Abstract

Background: Individuals with transhumeral limb loss have an increased risk of falling, potentially resulting from altered upper-body kinematics during gait. The purpose of this study was to investigate whole-body angular momentum as a measure of movement control, to gain an understanding of how these upper-body kinematics contribute to dynamic balance.

Methods: Eight participants with transhumeral limb loss and eight able-bodied control participants completed three gait trials at self-selected speeds. The participants with transhumeral limb loss performed trials with and without their prosthesis. Coefficient of cancellation and whole-body angular momentum about all anatomical axes of rotation were calculated. Means and variance were compared across the conditions over the gait cycle via statistical parametric mapping, and ranges were compared using a one-way ANOVA.

Findings: Coefficient of cancellation was decreased between the upper/lower extremities in the transverse plane and between the upper extremities/trunk in the sagittal plane for both transhumeral walking conditions compared to the control group. Whole-body angular momentum was statistically different in the sagittal plane and decreased in the transverse plane when walking with the prosthesis compared to the control group. Walking without the prosthesis resulted in increased variability of whole-body angular momentum.

Interpretation: Individuals with transhumeral limb loss had dysregulated whole-body angular momentum compared to the control group. This dysregulation was related to decreased segment-to-segment cancellation from the upper extremities and increased variance throughout the gait cycle. Based on these findings, individuals should be encouraged to wear their transhumeral prosthesis while walking as it may reduce fall risk and fatigue.

Keywords: Amputation; Balance; Gait; Prosthesis; Transhumeral.