Prosthetic Gait Training - StudyBlue

10/06/2017 · Gait training @ Prosthetic Solutions - Duration: ..

Outcome Measures for Prosthetic Gait training …

N2 - During recovery from a stroke, body weight-bearing on a paretic leg is spontaneously avoided. In physiotherapy for hemiparetic gait, as long as the patients can use their non-paretic leg, adaptive and compensatory strategies are always used to support and move the body. We examined the effects of gait training using prosthetics to induce the use of a paretic leg during walking. The prosthesis was applied to the non-paretic leg of three right hemiparetic patients. Prosthetic gait training was performed until finishing 5 successive motor learning sessions involving walking over 200 m and the changes of asymmetric gait performances were analyzed. The ground reaction forces during the initial stance phase of the paretic leg were increased in all patients after prosthetic gait training. Simultaneously, the propulsive force produced by the paretic leg was increased in 2 patients. By contrast, another patient developed more use of his non-paretic leg for propulsion corresponding to acquiring stability on the paretic leg, resulting in an improvement in single-support-time asymmetry. Task-specific effects provided by prosthetic gait training may be able to reorganize the motor strategy for hemiparetic gait by inducing the use of the paretic leg to support and propell the body.

Prosthetic Gait Training for Therapists..

AB - During recovery from a stroke, body weight-bearing on a paretic leg is spontaneously avoided. In physiotherapy for hemiparetic gait, as long as the patients can use their non-paretic leg, adaptive and compensatory strategies are always used to support and move the body. We examined the effects of gait training using prosthetics to induce the use of a paretic leg during walking. The prosthesis was applied to the non-paretic leg of three right hemiparetic patients. Prosthetic gait training was performed until finishing 5 successive motor learning sessions involving walking over 200 m and the changes of asymmetric gait performances were analyzed. The ground reaction forces during the initial stance phase of the paretic leg were increased in all patients after prosthetic gait training. Simultaneously, the propulsive force produced by the paretic leg was increased in 2 patients. By contrast, another patient developed more use of his non-paretic leg for propulsion corresponding to acquiring stability on the paretic leg, resulting in an improvement in single-support-time asymmetry. Task-specific effects provided by prosthetic gait training may be able to reorganize the motor strategy for hemiparetic gait by inducing the use of the paretic leg to support and propell the body.

In an effort to overcome this limitation, the hip flexion bias system was developed for the young, active amputee who wished to walk rapidly. At toe-off, kinetic energy from the coil spring is released, and the prosthetic thigh is thrust forward. Not only does this provide the amputee with a more normal-appearing gait, it also improves ground clearance. As a result, the prosthesis can be lengthened to a nearly level configuration in most cases (Fig 21B-5.). However, two potential problems have been noted with this approach. One is the development of annoying squeaks in the spring mechanisms after a few months of use, which sometimes tend to recur inexorably. A more significant concern is that as the spring compresses between heel strike and midstance, it creates a strong knee flexion moment. Unless this is resisted by a stance control knee with a friction brake or a polycentric knee with inherent stability, the patient may fall. Since the friction-brake mechanisms lose their effectiveness as the surface wears, the polycentric knee is the preferred component with this hip mechanism.


Gait Training & Mobility | Ability Prosthetics & Orthotics

Physical Therapists are instrumental in teaching a new amputee how to walk with their prosthesis. This usually occurs during a short stay in a local hospital or skilled nursing facility for what we call “gait training”. There, you will have therapy several times a day to teach you how to walk with your prosthesis. You will learn how to care for your prosthesis and what’s involved in maintaining it on a daily basis. One thing we preach for every amputee while in gait training, is quality over quantity. There are habits that an amputee can develop that make it more noticeable and use up more energy to walk. We want every amputee to perform to the best of their ability and we don’t want this process to be a race.

Gait Training and Socket Issues - Direct Skeletal Prosthesis

In the Normal-Speed Protocol, weight bearing on the short training prosthesis starts at 20 kg and is performed twice a day for 30 minutes. The patient is instructed to increase weight bearing by 10 kg each week until weight shifting to full body weight is achieved painlessly. Most patients report some pain during weight-bearing training, and pain recorded at VAS level 2 to 3 is considered safe. However, pain reported above VAS 5 should be avoided and weight-bearing exercises should be decreased to a more pain-free level. For all patients, the protocol includes 5 to 6 weeks of training with the short training prosthesis before prosthetic gait training on the definitive prosthesis starts. Thus, prosthetic gait training starts at about 12 weeks after S2 (). Using an Allen key, the patient secures the prosthesis to the abutment with an attachment device (). During the first 2 weeks, we instruct the patient to use the prosthesis a maximum of 2 hours/day, only indoors, and with the support of two crutches for very limited weight-bearing on the prosthetic foot. The prosthesis wearing time, as well as prosthetic activity and weight-bearing, is gradually increased in the following weeks. The patient achieves full-day prosthetic use after 4 to 6 weeks. During the first 3 months of prosthetic use, walking should be done with double support (crutches or sticks). Based on X-rays and the clinical status 6 months after S2, a decision is made by the team on walking without walking aid support both indoors and outdoors. Again, pain reported above VAS 5 should be avoided, and individual protocol progress should be slowed so as not to risk overloading the ongoing integration of bone structure, i.e., the ongoing OI process. To summarize, patients following the Normal-Speed Protocol are treated for about 12 months (from S1 to unrestricted prosthetic use). Patients with poorer skeletal conditions following the Half-Speed Protocol are treated for about 18 months.

Prosthetic gait training for lower extremity amputees …

This is now the standard for prosthetic fitting worldwide, and locking joints are very rarely necessary. A molded plastic socket encloses the ischial tuberosity for weight bearing, extends over the crest of the ilium to provide suspension during swing phase, and affords excellent mediolateral trunk stability by fully encasing the contralateral pelvis. The prosthetic hip joint is attached to the socket anteriorly, and this results in excellent stance-phase stability plus good swing-phase flexion.