There are approximately 170,000 persons in the United States who have lost a leg either surgically as a result of diabetes or bone cancer, lost a leg traumatically due to a traffic accident, and, in the case of men and women who have served in the armed forces, battle-related trauma. These individuals quickly learn that a prosthetic leg, in contrast to being a good substitute for a missing limb, is rather a means of getting around unaided. The early artificial legs were, in fact, props of carved wood or some other sturdy material that was attached to the waist or upper thigh with a complicated harness of straps and buckles. After World Wars I and II, a focused effort was made to improve prosthetic legs and, in doing so, the quality of life of the large number of amputees. The knee joints in the prosthesis used by transfemoral amputees used a variety of mechanisms for their operation, e.g., mechanical, pneumatic, hydraulic, and were a vast upgrade over their solid predecessors.
While these prosthetic legs required less energy to walk than their more primitive predecessors, the designs were still not without problems. Studies have shown that the persistent asymmetry in the gait of amputees results in greater demand being placed on their non-amputated limb. This higher demand leads to significantly higher rates of osteoarthritis. Further, the reduced demand in the residual limb leads to osteoporosis, and consequently increases the fracture risk. The advances in prosthetic design over the past century have been used widely and successfully. Nonetheless, advances in prosthetics have not kept pace with other technological advances of the times.
Recently, more sophisticated prosthetic joints have appeared on the market. People who have received these sophisticated devices have reported that it is easier for them to walk and that they are able to walk with less difficulty. It is thought that these bionic legs result in a more symmetrical gait and improved balance along with reduced energy required for walking. However, when individuals stumble or trip, they are more likely to fall and injure themselves, in spite of advances in prosthetics rehabilitation care. Based on our preliminary work, we have shown that it is possible, through training with a novel technology and method, to enhance the ability of the amputee to utilize their prosthetic limb in response to postural disturbances.
The goal of this project is to determine how to maximize the functional capabilities of individuals who have received a prosthetic leg. Our study has three main objectives. First, we will determine if the rehabilitation protocol improves the dynamic stability during postural disturbances of individuals who have previously completed a conventional training protocol. Second, we will determine if the new rehabilitation protocol can reduce the time required for rehabilitation of amputees to reach maximal functional improvement. Third, we will assess if the training can be retained. If the training protocol results in enhanced functional capability and/or accelerated rehabilitation, at the completion of this research award we will deploy the rehabilitation protocol system-wide throughout the military and Department of Veterans Affairs to amputee rehabilitation training sites.
|Effective start/end date||1/1/10 → …|
- Congressionally Directed Medical Research Programs: $2,359,000.00