Transtibial Amputee Study

by Alex Breen, Medical Physicist

A quantitative fluoroscopic study of the relationships between lumbar intervertebral and residual limb/socket kinematics in the coronal plane in adult male unilateral amputees.


Measuring the mechanics of the spine during motion is a challenge that has been largely overcome by the development of Quantitative Fluoroscopy (QF) technology . Moving x-ray images (fluoroscopic video images) are obtained from participants as they undergo a controlled bend of their spine. The whole sequence can be analysed by bespoke computer programs that both track the motion of the individual bones within the field of view and report their motion characteristics.

My work involves collecting, analysing and validating this data in a healthy control population while continuing to support development of the computer programs by which these images are processed and reviewed.

This technology is not restricted to the spine however, and as I undertake my PhD, I am using this technology not only to measure the kinematics the spine but also of the limb-prosthesis interface in unilateral below-knee amputees



This will use similar measurement techniques to those for the spine, but with the addition of others to investigate the effects of force distribution and posture.



The study protocol for which has undergone National Research Ethics and received favourable opinion in November 2013 from the NRES Committee South West reference 13/SW/0248.
The aim this PhD is to investigate if dynamic leg length discrepancies (LLD) in amputees with mature amputations cause changes in the passive properties of the lumbar spine. Previous studies have demonstrated an asymmetry in the stiffness of the spines of unilateral trans-tibial amputees as well as a high prevalence’s in changes in spinal posture and back pain in both lower limb amputees and persons with LLD greater than 2cm.

Alex has now completed his PhD. If you have any questions for him, please email him.




Anglo-European College of Chiropractic