A patient-oriented and musculoskeletal modeling approach to guide prosthetic design improvements and rehabilitation priorities for females with transtibial amputations

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dc.contributor.authorCarswell, Tess MR
dc.contributor.supervisorGiles, Joshua W.
dc.date.accessioned2025-12-15T16:38:22Z
dc.date.available2025-12-15T16:38:22Z
dc.date.issued2025
dc.degree.departmentDepartment of Mechanical Engineering
dc.degree.levelDoctor of Philosophy PhD
dc.description.abstractFemales with lower limb amputations are underrepresented in research and they experience unique challenges when compared to males. Addressing this research need, this PhD utilized principles of User-Centered Design, Patient-Oriented Research, gait analysis, and musculoskeletal modeling to recommend improvements of sex-specific rehabilitation and prosthetic design for people with transtibial amputations. A Patient-Oriented Research committee was developed, engaging females with lower limb amputations to inform research plans. This committee co-developed a behavioural research study, including novel questionnaire and interview instruments that actively engaged females with lower limb amputations in their development. From this study, quantitative and qualitative sex differences in the priorities of people with lower limb amputations were elucidated and informed plans for subsequent research efforts as well as recommendations put forward. A scoping review and evaluation of existing transtibial amputation musculoskeletal models was performed to determine the best to proceed with for computational modeling of sex differences in the gait of people with transtibial amputations. This resulted in a database of existing models, including the selected model to proceed with. With this model, computational analyses of biomechanical gait study data were performed. For the gait study, people with transtibial amputations and able-bodied participants completed level and sloped walking trials. Findings demonstrated sex differences in gait biomechanics of people with transtibial amputations and unique differences between females with transtibial amputations and able-bodied females not observed in the male comparisons, informing recommendations. Ultimately, findings were compiled to propose recommendations for further investigation of sex-specific rehabilitation priorities and prosthetic design. Namely, recommendations to perform sex-specific comparisons of gait for the purposes of rehabilitation or assessment of prosthetic technology, prioritize sex-specific rehabilitation towards female mobility needs, and investigate female-specific prosthetic ankle designs with additional propulsion and range of motion.
dc.description.embargo2026-12-03
dc.description.scholarlevelGraduate
dc.identifier.bibliographicCitationT.M.R. Carswell, B.G. Hordacre, M.D. Klimstra, and J.W. Giles, “Sex Differences in Spatiotemporal Gait Parameters of Transtibial Amputees,” Journal of Applied Biomechanics., pp. 1–9, Nov. 2022, doi: 10.1123/JAB.2022-0054.
dc.identifier.bibliographicCitationT.M.R. Carswell, H. Monkman, and J.W. Giles, “Exploring Sex Differences in the Needs and Priorities of People with Lower Limb Amputations: An Adaptation of the Prosthesis Evaluation Questionnaire,” Prosthetics and Orthotics International. Nov. 2024, doi: 10.1097/PXR.0000000000000375.
dc.identifier.bibliographicCitationT.M.R. Carswell, M. Hasan, and J.W. Giles, “A scoping review and evaluation of open-source transtibial amputation musculoskeletal models for use on female populations,” Prosthetics and Orthotics International. Sep. 2024, doi: 10.1097/PXR.0000000000000372.
dc.identifier.urihttps://hdl.handle.net/1828/22990
dc.languageEnglisheng
dc.language.isoen
dc.rightsAvailable to the World Wide Web
dc.subjectSex differences
dc.subjectMusculoskeletal modeling
dc.subjectPatient-oriented research
dc.subjectLower limb amputation
dc.subjectLower limb prosthetic design
dc.subjectRehabilitation
dc.subjectFemales with transtibial amputations
dc.titleA patient-oriented and musculoskeletal modeling approach to guide prosthetic design improvements and rehabilitation priorities for females with transtibial amputations
dc.typeThesis

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