Hachisuka K, Umezu Y, Ogata H, Ohmine S, Shinkoda K, Arizono H
Department of Rehabilitation Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J UOEH. 1999 Jun 1;21(2):107-18. doi: 10.7888/juoeh.21.107.
We examined 12 transfemoral amputees, 6 using the IRC socket and 6 the QL socket, to confirm whether the ischial-ramal containment (IRC) socket is truly superior to the quadrilateral (QL) socket. In subjective evaluation, the IRC group was significantly better in the total score and in items of comfort, that is, to sit on a chair and lumbar lordosis at heel off (Mann-Whitney test, P < 0.05), better but not significant in the items of comfortable to wear, comfortable to go up and down stairs, and truncal sway during stance phase. By computed tomography, the femur of the IRC group was kept in a position significantly more medial than that of the QL group (Mann-Whitney test, P < 0.05); but no significant difference in gluteal medial muscle atrophy ratios between the two groups was found (Mann-Whitney test, P > 0.05). By X-ray, the stump of the IRC group was maintained significantly more adducted during one foot standing on the prosthesis (Mann-Whitney test, P < 0.05), but the lateral force ratio during mid-stance of the IRC group was smaller, but not significantly, than that of the QL group. Physiological cost index (PCI), an indirect simple method for evaluating oxygen consumption of gait, had no significant difference between the two groups (Mann-Whitney test, P > 0.05), and a multiple regression analysis revealed that the stump length ratio and lateral force ratio during mid-stance were significant explanatory variables for predicting PCI (adjusted R square: 0.87, F-value: 11.85, P < 0.05). The results of this study have revealed that the advantage of the IRC socket is a tender feeling of the stump, but that the metabolic efficiency is not superior to the QL socket at the most comfortable speed.
我们对12名经股截肢者进行了检查，其中6人使用坐骨支包容（IRC）型接受腔，6人使用四边形（QL）型接受腔，以确认IRC型接受腔是否真的优于QL型接受腔。在主观评估中，IRC组在总分以及舒适度项目上表现明显更好，即在坐在椅子上以及足跟离地时腰椎前凸方面（曼-惠特尼检验，P<0.05），在穿着舒适、上下楼梯舒适以及站立期躯干摆动项目上表现较好但不显著。通过计算机断层扫描，IRC组的股骨位置比QL组明显更靠内侧（曼-惠特尼检验，P<0.05）；但两组之间臀中肌萎缩率没有显著差异（曼-惠特尼检验，P>0.05）。通过X射线检查，IRC组在单脚站立在假肢上时残肢明显更内收（曼-惠特尼检验，P<0.05），但IRC组在站立中期的侧向力比值比QL组小，但不显著。生理成本指数（PCI）是一种评估步态氧消耗的间接简单方法，两组之间没有显著差异（曼-惠特尼检验，P>0.05），多元回归分析显示，站立中期的残肢长度比值和侧向力比值是预测PCI的显著解释变量（调整R平方：0.87，F值：11.85，P<0.05）。本研究结果表明，IRC型接受腔的优势在于残肢有舒适感，但在最舒适速度下其代谢效率并不优于QL型接受腔。
