Can real-time visual feedback during gait retraining reduce metabolic demand for individuals with transtibial amputation?

Elizabeth Russell Esposito; Harmony S Choi; Benjamin J Darter; Jason M Wilken

doi:10.1371/journal.pone.0171786

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Can real-time visual feedback during gait retraining reduce metabolic demand for individuals with transtibial amputation?

Elizabeth Russell Esposito, Harmony S Choi, Benjamin J Darter and Jason M Wilken

PloS one, Vol.12(2), pp.e0171786-e0171786

2017

DOI: 10.1371/journal.pone.0171786

PMCID: PMC5300156

PMID: 28182797

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Abstract

The metabolic demand of walking generally increases following lower extremity amputation. This study used real-time visual feedback to modify biomechanical factors linked to an elevated metabolic demand of walking in individuals with transtibial amputation. Eight persons with unilateral, traumatic transtibial amputation and 8 uninjured controls participated. Two separate bouts of real-time visual feedback were provided during a single session of gait retraining to reduce 1) center of mass sway and 2) thigh muscle activation magnitudes and duration. Baseline and post-intervention data were collected. Metabolic rate, heart rate, frontal plane center of mass sway, quadriceps and hamstrings muscle activity, and co-contraction indices were evaluated during steady state walking at a standardized speed. Visual feedback successfully decreased center of mass sway 12% (p = 0.006) and quadriceps activity 12% (p = 0.041); however, thigh muscle co-contraction indices were unchanged. Neither condition significantly affected metabolic rate during walking and heart rate increased with center-of-mass feedback. Metabolic rate, center of mass sway, and integrated quadriceps muscle activity were all not significantly different from controls. Attempts to modify gait to decrease metabolic demand may actually adversely increase the physiological effort of walking in individuals with lower extremity amputation who are young, active and approximate metabolic rates of able-bodied adults.

Feedback, Sensory - physiology

Humans

Male

Gait - physiology

Tibia - surgery

Walking - physiology

Biomechanical Phenomena

Energy Metabolism

Physical Therapy Modalities

Adult

Amputation - rehabilitation

Computer Systems

Postural Balance - physiology

Amputation - methods

Details

Title: Subtitle: Can real-time visual feedback during gait retraining reduce metabolic demand for individuals with transtibial amputation?
Creators: Elizabeth Russell Esposito - Extremity Trauma and Amputation Center of Excellence, Ft. Sam Houston, Texas, United States of America
Harmony S Choi - Extremity Trauma and Amputation Center of Excellence, Ft. Sam Houston, Texas, United States of America
Benjamin J Darter - Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, United States of America
Jason M Wilken - Extremity Trauma and Amputation Center of Excellence, Ft. Sam Houston, Texas, United States of America
Resource Type: Journal article
Publication Details: PloS one, Vol.12(2), pp.e0171786-e0171786
DOI: 10.1371/journal.pone.0171786
PMID: 28182797
PMCID: PMC5300156
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: Public Library of Science; United States
Grant note: DOI: 10.13039/100006965, name: Telemedicine and Advanced Technology Research Center, award: W911QY-09-D-0043; DOI: 10.13039/100006108, name: National Center for Advancing Translational Sciences, award: KL2TR000057
Language: English
Date published: 2017
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984047997402771

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