Primary Objective: This study aims to analyze cycling gross efficiency, pedalling power symmetry, and hip, knee, ankle kinematics in adults with a transtibial amputation in different foot positions and seat heightsSecondary Objective(s): The second…
ID
Source
Brief title
Condition
- Other condition
- Muscle disorders
Synonym
Health condition
lower limb amputation
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Outcomes are gross efficiency, pedalling power symmetry, and kinematics of
lower limb in people with a transtibial amputation.
Pedaling power on each foot during the last minute of cycling (of each
condition) will be used to calculate pedaling power symmetry.
Hip, knee and ankle angles of each limb during the last minute of cycling will
be recorded through 2-dimensional kinematic assessment with a video camera.
Secondary outcome
The secondary outcome is the asymmetry index
Background summary
Cycling is one of the activities people with a lower limb amputation do in free
time or choose as a mode of transportation [6,9]. People with a transtibial
amputation due to trauma are the largest group of cyclists with an amputation
[6,9]. Able-bodied cyclists generate 12 to 21% of their power by the ankle
[3,4]. Although the ankle joint contribute less than the knee and hip joints,
people with a transtibial amputation have lost this contribution [12-14].
Consequently, cyclists with a transtibial amputation may cycle less
efficiently. Even though changing the foot positions on a pedal does not affect
the efficiency of competitive able-bodied cyclists (4,5), it may improve the
efficiency in cyclists with a TTA who use a passive device as prosthetic foot.
Prostheses are generally designed to mimic walking but are often also used for
recreational cycling. The range of motion in prosthetic feet varies [15,16],
but is usually smaller than the ankle range of motion of able-bodied during
cycling [15,16]. Hence, there is a need of hip and knee compensation. As a
result, kinematics of prosthetic and sound limb are not symmetrical. Besides,
prosthetic components or knee/hip contractures could prevent people with a
transtibial amputation to compensate for the reduced motion of the ankle. For
example, a socket can limit the ability to flex the knee [3] or contractures
could prevent the knee to extend. To accommodate with the individuals*
condition, raising or lowering the bicycle seat height might be helpful.
Moreover, an appropriate seat height could reduce the knee injury and increase
cycling efficiency [1,2].
Different seat heights affects cycling gross efficiency [1,2] and lower limb
kinematics in able-bodied cyclists [2]. Adjusting the seat height enables
cycling in people with a transtibial amputation [3]. Though foot positions did
not affect cycling economy in competitive able-bodied cyclists without the
amputation [4,5], it could affect gross efficiency differently in cyclists with
a transtibial amputation. There is limited knowledge about gross efficiency in
recreational cyclists with a transtibial amputation although 47% of them cycle
[7].
Study objective
Primary Objective: This study aims to analyze cycling gross efficiency,
pedalling power symmetry, and hip, knee, ankle kinematics in adults with a
transtibial amputation in different foot positions and seat heights
Secondary Objective(s): The second aim is to compare cycling gross efficiency,
pedalling power symmetry and lower limb kinematics between people with a
transtibial amputation and able-bodied adults in different foot positions and
seat heights. Third aim is to assess the relationship between kinetics
symmetries and gross efficiency, and kinematics symmetries and gross efficiency
in both groups.
Study design
This is a pilot study with repeated measures design. In total 12 adult people
with a transtibial amputation and 12 able-bodied cyclists matched for gender
and age will be recruited.
Intervention
The interventions are cycling foot positions and seat height. There will be no
interventional product/treatment.
Study burden and risks
Both groups of participants will visit lab two times and the total time for the
first and second visit will be about 30 and 90 minutes respectively.
Participants* maximal oxygen uptake (VO2max) will be determined. On visit 2,
participants will ride an ergometer for 6 trials. Each trial consists of a
6-minute submaximal cycling and 5-minute resting. Lower limb movement will be
filmed for kinematic analysis. Tools and protocols have been performed safely
in healthy individuals and people with a TTA in earlier research without any
report of adverse effects. For safety, the test will be terminated when the
subject fails to conform to the exercise test protocol, experiences adverse
signs or symptoms, requests to stop, or experiences an emergency situation [8].
CB41, PO Box 30001 30001
Groningen 9700 RB
NL
CB41, PO Box 30001 30001
Groningen 9700 RB
NL
Listed location countries
Age
Inclusion criteria
In order to be eligible for this study, a person must meet all of the following
criteria and give the written informed consent:
For persons with a transtibial amputation:
• Have been amputated more than 1 year ago
• History of cycling in the past 6 months with a prosthesis
• Unilateral TTA due to non-vascular disease
• age 18-65 years old
For able-bodied cyclists:
• History of cycling in the past 6 months
• age 18-65 years old
Exclusion criteria
For both groups, a potential subject who meets any of the following criteria
will be excluded from participation in this study:
* People with impairment of cognitive function that limit communication
ability, visual limitation, muscular (not related to the amputation) or
neurological conditions, a history of cardiovascular diseases and lung
diseases, lower limb motion and cardiorespiratory function.
* People with hip, knee, and ankle contractures.
* People who are or have been the professional cyclists.
* People with beta-blockers or other medication influencing heart beats
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL72943.042.20 |