Research Magazine

In Auburn University’s Locomotor and Movement Control Lab, improved mobility is the goal – for older adults, individuals with neurodegenerative disease, military personnel and more. A partnership between the lab – housed in the School of Kinesiology – and Walter Reed National Military Medical Center is improving lower-limb prosthetics for people who have had an amputation.

The research is made possible through a $492,250 grant from U.S. Army Medical Research, and it could lead to a better quality of life for veterans and others who have prosthetics for below-the-knee amputations. Currently, those individuals are given a prosthetic, but there are no guidelines for prosthesis selection. Dr. Jaimie Roper, director of the Locomotor and Movement Control Lab, is seeking to change that, with the help of others at Auburn University, the University of Pittsburgh, a team of scientists at Walter Reed National Military Medical Center and the Henry M. Jackson Foundation for the Advancement of Military Medicine.

At Auburn, collaborators include Dr. JoEllen Sefton, professor of kinesiology and director of both the Neuromechanics Lab and the Warrior Research Center; Dr. David Crumbley, associate clinical professor in the College of Nursing; Dr. David Shannon, professor of educational psychology and educational research, measurement and assessment as well as the Humana-Germany-Sherman Distinguished Professor in the College of Education; Dr. Michael Zabala, assistant professor of biomechanical engineering in the Samuel Ginn College of Engineering, and doctoral student Patrick Monaghan. Clair Smith, a statistician from the University of Pittsburgh, is also working on the project.

“Our ultimate goal is to develop a tool that can be used to help clinicians better select a prosthesis for people with amputations below the knee,” Roper said. “Clinicians are faced with numerous choices to prescribe a device. Oftentimes, selection is based on an individual clinician’s previous experience rather than a measurement.”

Selecting the best prosthetic device for each individual would contribute to enhanced movement, and Roper anticipates her research will develop a simplified, calculated way to determine what type of device may be best for an individual with an amputation.

The potential benefits would apply to clinicians and patients –including veterans – who have had a below-the-knee amputation.

“The results would be applied clinically and would allow clinicians to quickly select the best prosthetic,” Roper said. “This not only speeds up the initial device selection process, but it also improves the patient’s health, wellness and quality of life.”

For veterans, service members and civilians who use a lower-leg prosthetic, a better-fitting prosthetic can lead to improved outcomes. Without this clinical assessment tool to choose the best prosthetic for each patient, the patient’s health, comfort and engagement in activities can suffer.

“The results of this research would ensure proper care to service members, veterans and/or civilians,“ Roper said. “The patients will have an improvement in their current standard of care. This improvement in care will result in a reduction in time to have an ideal prosthetic fitting, a more rapid return to full function, reduced discomfort, reduced orthopedic complications, improved outcomes, increased activity level resulting in improved overall health and improved quality of life.”

The benefits are clear, and the research to develop a better prosthesis standard of care will take individual lifestyle factors into consideration.

“No two individuals are alike in terms of their demographics, risk factors, needs, preferences and abilities to perform real-world activities,“ Roper explained. “Improper initial device selection can lead to inefficiency in movement, pain, decreased balance that increases the likelihood of falls, decreased activity levels and increased costs.”

Roper’s goal for this research project is to develop a clinical assessment tool that will efficiently and effectively provide an objective prosthetic recommendation based on an individual’s characteristics, risk factors, needs and priorities and performance of activities of daily living.

Roper also said the results would simplify the process of getting a prosthetic device. Now, clinicians spend time finding the correct device, but with a tool that allows them to choose the correct device more quickly, patients and clinicians could spend more time on other aspects such as fitting, alignment and patient care.

“Ultimately, the results could lead to increased physical activity, mental health and overall wellness,” she said.

The development of the prosthesis fitting tool is expected to take up to 24 months. The research is being conducted on patients who have already been referred to Walter Reed National Military Medical Center due to a below-the-knee amputation.

Patients being studied are ages 18-80 and have been using a prosthesis for at least six months. The results from the research are expected to be available at the end of 2022.

The Locomotor and Movement Control Laboratory employs a comprehensive approach to develop impactful rehabilitation interventions to improve physical function and quality of life for both healthy and mobility impaired populations. The lab focuses on the interactions among biomechanical, sensorimotor and neurocognitive systems from diverse perspectives to better understand and address present challenges in movement and control. For more information, go to https://aub.ie/locomotor.

* The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work is supported by the Assistant Secretary of Defense for Health Affairs, through the Orthotics and Prosthetics Outcomes Research Program under Award No. W81XWH1810819. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.