title: Relief of knee flexion contracture and gait improvement following adaptive training for an assist device in a transtibial amputee: A case study.
abstract: BACKGROUND
  Management of a knee contracture is important for regaining gait ability in transtibial amputees. However, there has been little study of prosthesis training for enhancing mobility and improving range of motion in cases of restricted knee extension.
  
  
  OBJECTIVE
  This study aimed to evaluate the effects of adaptive training for an assist device (ATAD) for a transtibial amputee with a knee flexion contracture (KFC). A male transtibial amputee with KFC performed 4 months of ATAD with a multidisciplinary team. During the ATAD, the passive range of motion (PROM) in the knee, amputee mobility predictor (AMP) assessment, center of pressure (COP) on a force plate-equipped treadmill, gait features determined by three-dimensional motion analysis, and Short-Form 36 Item Health Survey (SF-36) scores were evaluated.
  
  
  RESULTS
  Following ATAD, PROM showed immediate improvement (135.6 ± 2.4° at baseline, 142.5 ± 1.7° at Step 1, 152.1 ± 1.8° at Step 2, 165.8 ± 1.9° at Step 3, and 166.0 ± 1.4° at Step 4); this was followed by an enhanced COP. Gradually, gait features also improved. Additionally, the AMP score (5 at baseline to 29 at Step 4) and K-level (K0 at baseline to K3 at Step 4) increased after ATAD. Along with these improvements, the SF-36 score also improved.
  
  
  CONCLUSIONS
  ATAD could be beneficial for transtibial amputees by relieving knee contractures and improving gait.
authors.forename: Sol-Bi
authors.initials: SB
authors.lastname: Kim
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Ko
authors.forename: Jinho
authors.initials: J
authors.lastname: Son
authors.forename: Sungjae
authors.initials: S
authors.lastname: Kang
authors.forename: Jeicheong
authors.initials: J
authors.lastname: Ryu
authors.forename: Museong
authors.initials: M
authors.lastname: Mun
mesh_terms: D000674:Amputees; D001186:Artificial Limbs; D001696:Biomechanical Phenomena / Q000502:physiology; D003286:Contracture / Q000534:rehabilitation*; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005684:Gait / Q000502:physiology*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D016059:Range of Motion, Articular / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: Adaptive training for assist device; gait ability; knee flexion contracture; quality of life; transtibial amputee