A caminhada humana é um movimento importante utilizado pelo homem, porém extremamente complexo em relação aos mecanismos energéticos e mecânicos que geram este movimento. O custo energético é maior na caminhada de amputados quando comparada a caminhada de indivíduos sem restrições físicas. Variáveis mecânicas e energéticas de amputados não foram extensivamente estudadas. Nosso objetivo foi avaliar a influência de diferentes velocidades, no recovery, no custo de transporte (C), na eficiência mecânica (Eff), na transdução pendular (Rint), trabalho mecânico, na estabilidade dinâmica, bem como verificar a associação entre a estabilidade dinâmica com recovery, custo de transporte e eficiência mecânica. Participaram do estudo 10 indivíduos amputados transfemurais (com joelho hidráulico e pé em fibra de carbono). Foi realizada cinemetria 3D (quatro câmeras de vídeo) e simultaneamente a análise do consumo de oxigênio. Foram determinadas cinco velocidades de caminhada, após definir a velocidade auto selecionada. Além da velocidade auto selecionada foram definidas duas velocidades acima e abaixo das VAS. Para os dados de Recovery, custo de transporte, eficiência mecânica, transdução pendular, trabalho total, trabalho externo, travalho vertical, trabalho horizontal, trabalho interno e estabilidade dinâmica foram utilizadas rotinas desenvolvidas em Matlab®. A velocidade influencia nos parâmetros mecânicos e energéticos da caminhada de amputados transfemurais. Os maiores valores para: economia de caminhada, Recovery, transdução pendular, eficiência mecânica, trabalho mecânico interno e vertical, e estabilidade dinâmica foram obtidos na máxima velocidade de caminhada dos sujeitos. As correlações entre o coeficiente de variação do comprimento da passada e Recovery, custo de transporte e potência metabólica foram moderadas. Esses resultados são de grande relevância para a área clínica e ponderados durante o processo de reabilitação desses indivíduos. / The human walking is an important movement used by man, but extremely complex in relation to the energetic and mechanical mechanisms that generate this movement. The energy cost of gait is greater in amputees than in normal subjects. Mechanical and energetics variables in amputees have not been extensively studied. Our objective was to assess the influence of speed in recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), mechanic parameters, dynamical stability, well as to verify agreement between dynamical stability with recovery, C, Eff and metabolic power. Materials and Methods: ten transfemoral amputees (with hydraulic knee and carbon fiber foot) were selected in the study. Simultaneously three-dimensional (3D) kinematics data (four cameras) and oxygen consumption were collected at five speeds, two above and two below self-select one. The Recovery, C, Eff, Rint, dynamical stability, were processed using Matlab software. Mechanics and energetics of amputee walking were influenced by speed. In maximal speed of amputee walking were reported greatest values, like: recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), internal and vertical mechanical work and dynamical stability. Pearson correlation between dynamical stability and Recovery, C, Eff and metabolic power were moderate. These results are clinical relevance and should be considered during the rehabilitation of these individuals.

A caminhada humana é um movimento importante utilizado pelo homem, porém extremamente complexo em relação aos mecanismos energéticos e mecânicos que geram este movimento. O custo energético é maior na caminhada de amputados quando comparada a caminhada de indivíduos sem restrições físicas. Variáveis mecânicas e energéticas de amputados não foram extensivamente estudadas. Nosso objetivo foi avaliar a influência de diferentes velocidades, no recovery, no custo de transporte (C), na eficiência mecânica (Eff), na transdução pendular (Rint), trabalho mecânico, na estabilidade dinâmica, bem como verificar a associação entre a estabilidade dinâmica com recovery, custo de transporte e eficiência mecânica. Participaram do estudo 10 indivíduos amputados transfemurais (com joelho hidráulico e pé em fibra de carbono). Foi realizada cinemetria 3D (quatro câmeras de vídeo) e simultaneamente a análise do consumo de oxigênio. Foram determinadas cinco velocidades de caminhada, após definir a velocidade auto selecionada. Além da velocidade auto selecionada foram definidas duas velocidades acima e abaixo das VAS. Para os dados de Recovery, custo de transporte, eficiência mecânica, transdução pendular, trabalho total, trabalho externo, travalho vertical, trabalho horizontal, trabalho interno e estabilidade dinâmica foram utilizadas rotinas desenvolvidas em Matlab®. A velocidade influencia nos parâmetros mecânicos e energéticos da caminhada de amputados transfemurais. Os maiores valores para: economia de caminhada, Recovery, transdução pendular, eficiência mecânica, trabalho mecânico interno e vertical, e estabilidade dinâmica foram obtidos na máxima velocidade de caminhada dos sujeitos. As correlações entre o coeficiente de variação do comprimento da passada e Recovery, custo de transporte e potência metabólica foram moderadas. Esses resultados são de grande relevância para a área clínica e ponderados durante o processo de reabilitação desses indivíduos. / The human walking is an important movement used by man, but extremely complex in relation to the energetic and mechanical mechanisms that generate this movement. The energy cost of gait is greater in amputees than in normal subjects. Mechanical and energetics variables in amputees have not been extensively studied. Our objective was to assess the influence of speed in recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), mechanic parameters, dynamical stability, well as to verify agreement between dynamical stability with recovery, C, Eff and metabolic power. Materials and Methods: ten transfemoral amputees (with hydraulic knee and carbon fiber foot) were selected in the study. Simultaneously three-dimensional (3D) kinematics data (four cameras) and oxygen consumption were collected at five speeds, two above and two below self-select one. The Recovery, C, Eff, Rint, dynamical stability, were processed using Matlab software. Mechanics and energetics of amputee walking were influenced by speed. In maximal speed of amputee walking were reported greatest values, like: recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), internal and vertical mechanical work and dynamical stability. Pearson correlation between dynamical stability and Recovery, C, Eff and metabolic power were moderate. These results are clinical relevance and should be considered during the rehabilitation of these individuals.

A caminhada humana é um movimento importante utilizado pelo homem, porém extremamente complexo em relação aos mecanismos energéticos e mecânicos que geram este movimento. O custo energético é maior na caminhada de amputados quando comparada a caminhada de indivíduos sem restrições físicas. Variáveis mecânicas e energéticas de amputados não foram extensivamente estudadas. Nosso objetivo foi avaliar a influência de diferentes velocidades, no recovery, no custo de transporte (C), na eficiência mecânica (Eff), na transdução pendular (Rint), trabalho mecânico, na estabilidade dinâmica, bem como verificar a associação entre a estabilidade dinâmica com recovery, custo de transporte e eficiência mecânica. Participaram do estudo 10 indivíduos amputados transfemurais (com joelho hidráulico e pé em fibra de carbono). Foi realizada cinemetria 3D (quatro câmeras de vídeo) e simultaneamente a análise do consumo de oxigênio. Foram determinadas cinco velocidades de caminhada, após definir a velocidade auto selecionada. Além da velocidade auto selecionada foram definidas duas velocidades acima e abaixo das VAS. Para os dados de Recovery, custo de transporte, eficiência mecânica, transdução pendular, trabalho total, trabalho externo, travalho vertical, trabalho horizontal, trabalho interno e estabilidade dinâmica foram utilizadas rotinas desenvolvidas em Matlab®. A velocidade influencia nos parâmetros mecânicos e energéticos da caminhada de amputados transfemurais. Os maiores valores para: economia de caminhada, Recovery, transdução pendular, eficiência mecânica, trabalho mecânico interno e vertical, e estabilidade dinâmica foram obtidos na máxima velocidade de caminhada dos sujeitos. As correlações entre o coeficiente de variação do comprimento da passada e Recovery, custo de transporte e potência metabólica foram moderadas. Esses resultados são de grande relevância para a área clínica e ponderados durante o processo de reabilitação desses indivíduos. / The human walking is an important movement used by man, but extremely complex in relation to the energetic and mechanical mechanisms that generate this movement. The energy cost of gait is greater in amputees than in normal subjects. Mechanical and energetics variables in amputees have not been extensively studied. Our objective was to assess the influence of speed in recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), mechanic parameters, dynamical stability, well as to verify agreement between dynamical stability with recovery, C, Eff and metabolic power. Materials and Methods: ten transfemoral amputees (with hydraulic knee and carbon fiber foot) were selected in the study. Simultaneously three-dimensional (3D) kinematics data (four cameras) and oxygen consumption were collected at five speeds, two above and two below self-select one. The Recovery, C, Eff, Rint, dynamical stability, were processed using Matlab software. Mechanics and energetics of amputee walking were influenced by speed. In maximal speed of amputee walking were reported greatest values, like: recovery, cost of transport (C), mechanical efficiency (Eff), pendular transduction (Rint), internal and vertical mechanical work and dynamical stability. Pearson correlation between dynamical stability and Recovery, C, Eff and metabolic power were moderate. These results are clinical relevance and should be considered during the rehabilitation of these individuals.

Bakgrund Att ha en transfemoral (TF) amputation har en stor inverkan på den amputerades liv med bl.a. större risk för fall, lägre gånghastighet och smärta. I dag är utbudet av kvalitativa studier som visar på hur TF-amputerade upplever sin vardag, mycket begränsat. Det saknas helt studier som tar upp hur det är att ha ett föräldraansvar när man är TF-amputerad.    Syfte Syftet med studien var att se om det fanns några självupplevda problem i vardagen för unilateralt TF-amputerade i föräldrarollen kopplad till deras protes-användning.   Metod Kvalitativa semistrukturerade intervjuer genomfördes med fyra TF-amputerade pappor. Dessa analyserades och tematiserades.    Resultat Vid analysen hittades nio huvudteman: Ansvar, relation med barnen, svårigheter med spontanitet, aktiviteter, miljörelaterade problem, oro, energi och smärta, säkerhet.  Deltagarna upplevade bristande delaktighet, fler konflikter med sina barn och bristande energi.    Slutsats Det finns ett flertal självupplevda problem för TF-amputerade föräldrar och dessa berör främst känslan av delaktighet, relationen med barnen så väl som rent praktiska aspekter. / Background Having a transfemoral (TF) amputation has a major impact on the amputee's life, such as greater risk of falls, lower walking speed and pain. Today, there are no qualitative studies that show how TF-amputees experience their everyday lives and there are no studies that address what it is like to have parental responsibility when you are TF-amputated.   Purpose The aim of this study was to see if there were any self-experienced problems in the everyday life of unilateral TF amputees in the parental role linked to their prosthetic use.   Method Qualitative semi-structured interviews were conducted with four TF-amputated fathers. These were analysed and thematised.   Results Nine main themes were detected during the analysis: Responsibility, relationship with the children, difficulties with spontaneity, activities, environment-related problems, concern, energy and pain and safety. Participants experienced lack of participation, more conflicts with their children and lack of energy.   Conclusion There are self-experienced problems for TF-amputated parents, and these affect the sense of participation, the relationship with the children and practical aspects

The purpose of this literature review was to identify any adaptations that could be made to the rehabilitation process for Traumatic Transfemoral Amputees. Traumatic Transfemoral Amputation is particularly debilitating with the amputees encountering many obstacles throughout the rehabilitation process. These obstacles can prevent the return to pre-morbid functioning. With an ever-increasing number of amputees within the United States, it is imperative the rehabilitation process be addressed. This literature review addresses possible adjustments in the initial stages of rehabilitation examining the post-operative, pre-prosthetic, and prosthetic rehabilitation stage to enhance the physical functioning for the amputee. This comprehensive literature review encompassing 63 academic and medical journals analyzes the research literature regarding each of the three stages of the post-operative procedure. The literature review synthesizes the research findings to see how procedures may be adapted to reduce the risk of further co-morbidities such as loss of bone mineral density and disuse atrophy. Loss of bone mineral density and disuse atrophy are the major contributing factors to the amputees decreased mobility. Reducing this loss can be addressed within the initial post-operative, pre-prosthetic, and prosthetic rehabilitation stages. Further research is required to examine the efficacy of these alterations in relation to this specific population.

Tyrimo objektas: fantominio skausmo ir raumenų jėgos pokytis po kineziterapijos ir grįžtamojo ryšio. Tyrimo tikslas: įvertini kineziterapijos ir grįžtamojo ryšio poveikį fantominiams skausmams ir šlaunies raumenų jėgai po šlaunies amputacijos. Hipotezė: manome, kad taikant kineziterapiją ir grįžtamąjį ryšį po šlaunies amputacijos, fantominių skausmų intensyvumas sumažės ir šlaunies raumenų jėga padidės labiau, nei taikant kineziterapiją be grįžtamojo ryšio. Uždaviniai: 1. Palyginti fantominių skausmų intensyvumą ir šlaunies raumenų jėgą po šlaunies amputacijos kineziterapijos pradžioje ir po įprastinės be grįžtamojo ryšio kineziterapijos. 2. Palyginti fantominių skausmų intensyvumą ir šlaunies raumenų jėgą po šlaunies amputacijos kineziterapijos pradžioje ir po kineziterapijos kartu su grįžtamuoju ryšiu. 3. Palyginti įprastinės kineziterapijos ir kineziterapijos kartu su grįžtamuoju ryšiu poveikį fantominių skausmų intensyvumui ir šlaunies raumenų jėgai. Rezultatai: Tyrimo pradžioje, kontrolinės grupės tiriamieji fantominį skausmą įvertino 6,17±0,75, tiriamosios grupės tiriamieji – 6,83±0,75 balais. Tyrimo pabaigoje, kontrolinė grupė – 5,86±0,75, tiriamoji grupė – 5,17±0,75 balais. Prieš kineziterapiją kontrolinėje grupėje, po amputacijos, šlaunį tiesiančių raumenų jėga buvo 3,00±0,00, lenkiančių – 3,33±0,52, pritraukiančių – 2,83±0,51 ir atitraukiančių – 2,50±0,55 balų; tiriamojoje grupėje, šlaunį lenkiančių raumenų jėga buvo 3,17±0,47, tiesiančių – 3,00±0,00... [toliau žr. visą tekstą] / The object: effects of physiotherapy with mirror therapy for phantom pain and thigh muscle strength after transfemoral. The objective: the alteration of phant pain and thigh muscle after physiotherapy and mirror therapy. Hyptohesis: We consider, that the application of physiotherapy with mirror therapy helps to reduce phantom pain and improve muscle strenght better than physiotherapy without mirror therapy. The aims: 1. To compare phantom pain and muscle force in the beginning of physiotherapy and after physiothepy. 2. To compare phantom pain and muscle force in the beginning of physiotherapy and after physiotherapy with mirrot therapy. 3. To compare physiotherapy with mirror therapy and physiotherapy without mirror therpy for phantom pain and muscle force. Results: Beginning of the study, the control group subjects phantom pain score 6.17 ± 0.75, experimental group subjects - 6.83 ± 0.75 points. End of the study, the control group - 5.86 ± 0.75, experimental group - 5.17 ± 0.75 points. Before physical therapy in the control group after the amputation, the thigh muscle stretching force was 3.00 ± 0.00, flexion - 3.33 ± 0.52, attracting - 2.83 ± 0.51 and distracting - 2.50 ± 0.55 scores, the experimental group, the thigh, the muscle strength was 3.17 ± 0.47, stretching - 3.00±0.00, attracting - 2.67±0.47 and distracting-2.83±0.37 points. Application of physical therapy procedures, after 3 weeks, the control group, after the amputation, the thigh flexion strength was 4.33 ± 0... [to full text]

Transfemoralor above-the-knee amputees face discomfort in their prothesis primarily due to irregular distribution of pressure and shear forces in the Socket-stump interface (SSI). To quantify this discomfort it is necessary to first determine the pressure distribution in the SSI using sensors. However, knowledge of how sensors should be deployed is necessary to support the testing of said pressure on a test-rig or amputee. Previous methods used to determine sensor placement include discretization of the SSI into several regions or the use of a reiterative method based on pressure readings from sensors to determine the optimal placement of sensors. The former fails to identify high regions of pressure as the regions covered by the sensors may not have high pressure whereas the latter is time consuming and may cause further trauma to amputees as it requires repeated experimentation. With the advances in pressure sensor technologies, biomechanical simulations, and Finite elementanalysis(FEA)simulations it is now increasingly possible to determine an accurate estimate of dynamic pressure distribution occurring in the SSI during the gait cycle. The thesis investigates the dynamic pressure distribution in the SSI and determines an effective method of locating the optimal positions for the sensors using two different algorithms. The first is a Genetic Algorithm whereas the second is Pattern Search. / Transfemorala eller amputerade över knäet möter obehag i sin protes främst på grund av oregelbunden fördelning av tryck och skjuvkrafter i SSI. För att kvantifiera detta obehag är det nödvändigt att först bestämma tryckfördelningen i SSI med hjälp av sensorer. Men kunskap om hur sensorer ska distribueras är nödvändig för att stödja testningen av nämnda tryck på en testrigg eller amputerad. Tidigare metoder som använts för att bestämma sensorplacering inkluderar diskretisering av SSI i flera regioner eller användning av en upprepad metod baserad på tryckavläsningar från sensorer för att bestämma den optimala placeringen av sensorer. Den förstnämnda misslyckas med att identifiera höga tryckregioner eftersom den områden som täcks av sensorerna kanske inte har högt tryck medan de senare är tidskrävande och kan orsaka ytterligare trauma för amputerade eftersom det kräver upprepade experiment. Med framstegen inom trycksensorteknologier, biomekaniska simuleringar och FEA-simuleringar är det nu alltmer möjligt att bestämma en exakt uppskattning av dynamisk tryckfördelning i SSI under gångcykeln. Avhandlingen undersöker den dynamiska tryckfördelningen i SSI och bestämmer en effektiv metod för att lokalisera de optimala positionerna för sensorerna med hjälp av två olika algoritmer. Den första är en genetisk algoritm medan den andra är mönstresökning

Diploma thesis "Effect of gait school with prosthesis on stability and walking parameters of patients after transfemoral amputation deals with problems of patients after transfemoral amputation due to vascular etiology. It mentions elementary knowledge of rehabilitation after amputation of lower extremity. Furthermore, there are described main complications that amputation brings into the patient ́s life: pain associated with amputation, skin complications and psychological hardships. Emphasis is laid on gait and gait practice for patients with amputation. I further deal with deviations commonly observed on gait of these patients and with factors influencing the gait, including the influence of particular parts of the prosthesis on patients ́ gait. The practical part is dedicated to comparison of two different approaches to gait practice. The effect of these approaches is evaluated on the basis of results of two groups of patients. The results were gathered by examination on force plate, measurement of gait velocity, examination of gait cadence and evaluation of patients ́s gait videos. Furthermore, I use functional tests: LCI - 5, ABIS - R, ABC scale and PEQ. All of these examinations were performed at the beginning and in the end of patients ́ stay at the Clinic of rehabilitation in Hradec Králové. The...

The subject of this dissertation was the creation of the adapted exercise program for unilateral transfemoral amputees and its verification in practice. The content of this program was chosen based on the practical experience and theoretical background in the field of anatomy, kinesiology, rehabilitation, lower- limb amputations and Motion Capture technologies. The four-month intervention program was designed as an adapted corrective exercise aimed at the major muscle groups influencing the posture, especially the position of the pelvic segment, which is the dominant element in the kinematic chain. The aim of this project was to ascertain whether this intervention can affect the pelvic tilt (in frontal and sagittal plane) of unilateral transfemoral amputees and so improve their quality of life. This was a project based on combination of quantitative and qualitative research methods. The measurement of the size of angles determining the pelvic tilt by Qualisys optoelectronic system was the essence of the quantitative part of the research. Qualitative data were collected through semi-structured in-depth interviews from persons who completed whole project. This research is by its nature and focus characterized as a set of case reports and as a pilot study, proof of concept respectively. 10 unilateral...