Understanding the musculoskeletal function of lower limb amputees
Research type
Research Study
Full title
Understanding the musculoskeletal function of lower limb amputees
IRAS ID
204835
Contact name
A.M.J Bull
Contact email
Sponsor organisation
Imperial College London
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Summary of Research
The last few decades of conflict involving US and UK troops in the Middle East, and the increase in use of the improvised explosive device (IED) as an offensive weapon by the enemy, has resulted in an increase in the number of young, motivated traumatic military lower-limb amputees. The effect on locomotion of amputation has long been studied. Less well known, however, are the effects that amputation has on the mechanical ability of the musculoskeletal system.
A computational musculoskeletal model creates a series of human tissue models in the musculoskeletal system including muscle, tendon, ligament, and articulated surface. With the input of human motion and external forces when body segments contact the environment, it calculates mechanical loads in the musculoskeletal system such as the muscle force, ligament force and articulated contact force. Through the use of conventional musculoskeletal modelling techniques, this study aims to quantify and analysis the mechanical function in the musculoskeletal system of the lower limb amputees, and to identify and understand deficiencies in their movement strategy. Through the identification of these deficiencies, it becomes possible to design individualised and optimised intervention strategies that offer potential for improved performance in activities of daily living (ADLs) and in sport, as well as improving amputee comfort and long term health outcome.
The outcomes of the study include: 1) to create a set of musculoskeletal models for military lower-limb amputees through the use of medical imaging, motion data, muscle strength data and surface electromyography(EMG) data; 2) to understand the mechanical function of the musculoskeletal system for lower limb amputees through musculoskeletal modelling and simulation of ADLs.Summary of Results
This study first investigated lower limb muscle volume adaptations to bilateral transfemoral amputation. The analysis identified significant larger muscle volume of the muscles that were not affected by the surgery compared to persons without limb loss. The second part of the study assessed the musculoskeletal burden in the bilateral transfemoral amputee population compared to persons without limb loss. Subject-specific computational models were developed using the collected magnetic resonance imaging scans and motion data. It was demonstrated that for similar walking speeds, bilateral transfemoral amputees have higher muscle and hip joint contact forces compared to able-bodied persons. The higher muscle forces may lead to early onset of muscular tiredness for a given task. Similarly, the higher hip joint contact forces indicate higher risk of mechanically driven osteoarthritis. The results of this study enable the development of optimised intervention protocols, surgical methods and prosthetic devices that promote optimal functional abilities and bone health within the population of persons with limb loss.REC name
London - Central Research Ethics Committee
REC reference
16/LO/1715
Date of REC Opinion
7 Oct 2016
REC opinion
Favourable Opinion