Kinetic asymmetry in transfemoral amputees while performing sit to stand and stand to sit movements

Transitional movements are a determinant of functional independence and have limited study in amputees. Microprocessor prosthetic knees' abilities to assist transfemoral amputees with sitting and standing have not been studied. Through cross-sectional study, 21 transfemoral amputees, divided into 3 groups of 7 by knee type (power knee, C-leg, Mauch SNS) and 7 non-amputee controls (n = 28) performed sit to stand and stand to sit while kinematic and kinetic data were recorded. Transfemoral amputees can stand (1.6-2.0 s) and sit (2.1-2.8 s) at rates comparable to controls (1.6 s). Controls' ground reaction force (GRF) and knee moment production was <7% asymmetric and superior to amputees' during both movements. For sit to stand, amputees' asymmetry for GRF ranged from 53 to 69% and 110 to 124% for knee moments. For stand to sit, amputees' asymmetry for GRF ranged from 32 to 60% and 84 to 114% for knee moments. Hip moment asymmetry for sit to stand was less for control (21%) and power knee (34%) groups than that produced by the Mauch SNS (59%) group. For stand to sit, hip moment production for the Mauch SNS (47%) and C-leg groups (71%) were more asymmetric than controls (19%). In the majority of cases transfemoral amputees do not load their prosthesis extensively for standing up or sitting down. Therefore, this transitional movement is currently a one-legged task, which increases stress on the sound limb. Generally, the prosthetic knees studied did not produce a significant knee moment in either task. Although most differences between knee groups were not statistically significant, differences may be clinically meaningful on an individual basis.