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IMPACT OF AMPUTATION LEVEL AND VAULTING ON LOADING PARAMETERS DURING LEVEL GROUND WALKING
No full textBACKGROUND: Previous studies show that during level walking, the load on the contralateral side increases with more proximal amputation levels. Furthermore, a typical compensation mechanism, vaulting on the contralateral side, may also influence the load. However, no study has compared the load applied to the contralateral side across more than two different amputation levels.
OBJECTIVE: The objectives of this study were to analyze the biomechanical impact of different lower limb amputation levels and vaulting on the load applied to the locomotor system.
METHODOLOGY: Gait data from 82 individuals with different amputation levels (44 transtibial (TT), 30 transfemoral (TF), and 8 hip disarticulation (HD)) were retrospectively analyzed in this study. Peak knee adduction, flexion and extension moments, vertical ground reaction force peaks, and force rates were statistically analyzed between different amputation levels and between two groups “TF with vaulting” and “TF without vaulting”.
FINDINGS: As the level of amputation increases, walking speed decreases and asymmetry of stance duration increases. TF individuals with vaulting tend to walk faster than those without vaulting. The first peak of vertical ground reaction forces, the peak knee adduction and extension moments increase, and the peak knee flexion moments decrease with higher amputation level. The higher the amputation level, the curve of the vertical ground reaction force becomes significantly steeper during the first 5% of the gait cycle (GC). The first peak of ground reaction forces, the knee flexion, extension and adduction moments tend to be higher in TF individuals with vaulting.
CONCLUSION: In summary, a higher lower limb amputation level can increase loading on the contralateral limb and contribute to a higher incidence of vaulting during gait. The effect of vaulting as a compensation pattern leads to an additional increase in contralateral limb loading.
Layman\u27s Abstract
Gait characteristics in people using lower limb prostheses deviate from normal gait patterns in individuals without amputation. Furthermore, some people with amputation rise onto the toes of their intact side (a movement known as vaulting) as a compensatory mechanism during walking, which helps them clear the ground on the prosthetic side. In people with lower limb amputation, the load applied to the intact side during level walking is higher compared to able-bodied individuals, and it increases as the level of amputation progresses from below the knee to hip disarticulation. No previous study has compared the load applied to the intact side across more than two different amputation levels. The aims of the present study were to analyze the influence of the amputation level and of vaulting on the load applied to the lower limb. Therefore, we analyzed previously collected gait data from 82 individuals with amputation (44 transtibial, 30 transfemoral, and 8 with hip disarticulation). As the level of amputation increases, walking speed decreases and individuals tend to spend more time on the intact side than the prosthetic side during each gait cycle. Individuals with transfemoral amputation who use vaulting as a compensatory movement tend to walk faster than those who do not use this strategy and experience higher forces on the intact limb. As the level of amputation increases, most of the forces applied to the body during level walking also increase. Furthermore, vaulting is more common in individuals with higher amputation levels.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/44416/33698
How To Cite: Pröbsting E, Schmalz T, Bellmann M. Impact of amputation level and vaulting on loading parameters during level ground walking. Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 1, No. 2. Https://doi.org/10.33137/cpoj.v8i1.44416
Corresponding Author: Eva Pröbsting, Dipl.-Ing (FH)Affiliation: Clinical Research and Services, Research Biomechanics, Ottobock SE & Co. KGaA, Göttingen, Germany.E-Mail: [email protected] ID: https://orcid.org/0000-0002-6349-299
Noteworthy Insights at the Personal and Community Level – people with mental health difficulties and meaningful social spaces
No full textObjective: The core value underlying this study is social inclusion. This paper studies how people with mental health difficulties find meaningful everyday life and identity as members of the community. The study focuses on the experiences and perspectives of individuals with mental health difficulties and their view and interpretation of connections with spaces, places, and people in the communities. It is essential to include their voices and actively involve them in the research process to comprehensively understand their needs, preferences, and goals concerning community-based recovery.
Research Design and Methods: The research exhibits novelty in two fundamental aspects:18 persons with mental health difficulties participated as co-researchers, and for data collection, creative methods were used (creative writing, photovoice, etc.). Co-researchers live in apartment buildings in ordinary neighbourhoods and receive supported housing services in three Estonian cities.
The data was analyzed using thematic analysis. The study combined creative methods such as diary entries, collages, or photovoice to include the first-person perspectives. Involving people with mental health difficulties acting as co-researchers is an innovative approach to this study.
Results: The results identify the effect social interaction and visiting various places in the community can have on people. A place will have a deeper meaning for the person visiting when it relates to memories, emotions, supporting people, and likeable activities they can do there.
Conclusions: It is important for the recovery process that people with mental health difficulties spend time in an environment that is suitable – flexible, appreciative, and supportive of development for them, providing both visual satisfaction, varieties of activity, and undemanding sociality, i.e. possibility to be connected with other people
Encroaching Borders and Defencelessness of Migrants at Checkpoints in Southern Mexico
No full textAfter an intimidating experience I had during a checkpoint on the southern border of Mexico in 2023, I began to investigate the prevalence and impacts of immigration checkpoints. Despite having been declared unconstitutional by the Mexican Suprema Corte de Justicia de la Nación (Supreme Court of Justice) in 2022, checkpoints are still one of the most common and least regulated practices to detain people on the move, especially in the context of anti-drug operations. In this paper, I show how checkpoints have become a violent infrastructure dispersed across the Mexican territory. The flexibility and mobility of checkpoints and the actors administering them—governmental actors, extra-legal groups, and criminal networks—expose migrants to racialized and gendered forms of extreme violence and human rights violations. I present the findings of research conducted in 2022 and 2023 in the city of Tapachula, Chiapas, and its surroundings, consisting of participant observation and interviews with migrants who interacted with the Guardia Nacional (National Guard) during waiting, transit, or detention. I also interviewed ten civil society organizations that provide psycho-legal assistance to migrant people detained at checkpoints throughout the country. I analyze how, in hazardous conditions, being stopped in a checkpoint while traveling in Mexican highways can generate intimidation and defenselessness against all kinds of human rights violations.
Resumen
Tras haber vivido una experiencia intimidante durante un control fronterizo en el sur de México en 2023, comencé a investigar la prevalencia y los impactos de los retenes en carreteras para las personas migrantes. A pesar de que en 2022 la Suprema Corte de Justicia de la Nación declaró la inconstitucionalidad de las revisiones migratorias al interior del país, los retenes siguen siendo una de las prácticas más comunes y menos reguladas para detener a las personas en movilidad, especialmente en el contexto de los operativos antidrogas. En este artículo analizo los retenes en carreteras que funcionan como infraestructuras violentas dispersas por todo el territorio mexicano. Tanto su flexibilidad y movilidad, como los actores que los operan—actores gubernamentales, grupos extralegales y redes criminales—exponen a las personas migrantes a formas de violencia racializadas y de género y a serias violaciones de los derechos humanos. Presento los resultados de una investigación realizada en 2022 y 2023 en la ciudad de Tapachula, Chiapas, y sus alrededores, que consistió observación participante y entrevistas con personas migrantes que interactuaron con la Guardia Nacional durante los procesos de espera, tránsito o detención. Incluyo las entrevistas realizadas a diez organizaciones de la sociedad civil que brindan acompañamiento psico-jurídico a personas migrantes detenidas en retenes a lo largo de todo el país. Analizo cómo, en condiciones de riesgo, la detención en un retén por las carreteras mexicanas puede generar intimidación e indefensión ante todo tipo de violaciones de derechos humanos
A Review of Doing the Right Thing
No full textDoing the Right Thing
by Tom Cooper
UK: Academic Publishing, 202