Contact: Mark Geil
Publications:
Geil, MD. Variability among practitioners in dynamic observational alignment of a transfemoral prosthesis. Journal of Prosthetics and Orthotics. 14(4), 159-164, 2002.
Geil, MD, Lay, AM. Plantar foot pressure responses to changes during dynamic transtibial alignment in a clinical setting. Prosthetics and Orthotics International. 28, 105-114, 2004.
Overview:
Alignment is the spatial orientation of prosthetic components with respect to one another. During the process of dynamic alignment, a prosthetist observes an amputee's gait and makes necessary alterations from the baseline "bench" alignment to improve locomotion. Alterations can occur at any joint and at any plane and can take the form of rotational or translational adjustment.
This line of
research explores the process of dynamic alignment to address both clinically
applied and theoretical questions. Clinically, the dynamic alignment process is
subjective and some have questioned its repeatability. We have investigated the
consistency of multiple practitioners conducting dynamic alignment for the same
amputee. We have also assessed the effects of dynamic alignment on plantar
pressure, with a goal of defining a range of alignments to which the amputee's
neuromusculoskeletal system is sensitive.
In a more theoretical sense, perturbations to prosthesis alignment can be expected to produce altered gait patterns. Additional research is exploring acute amputee response to large perturbations in alignment. Refinement of locomotor strategies over a few steps is revealing possible optimization criteria employed by the amputee when walking with a prosthesis.