Goh J C H, Lee P V S, Chong S Y
Department of Orthopaedic Surgery, The National University of Singapore, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
Clin Biomech (Bristol). 2003 Mar;18(3):237-43. doi: 10.1016/s0268-0033(02)00206-1.
The aim was to evaluate stump/socket interface pressure in amputees wearing a socket developed by a pressure casting system.Design. Five unilateral transtibial amputees wore a pressure cast socket and walked at a self-selected speed.
The socket produces equally distributed pressure at the stump/socket interface, deviating from the conventional belief that pressure varies in proportion to the pain threshold of different tissues in the stump.
The socket was fabricated while the subject placed his stump in a pressure chamber. Pressure was applied while he adopted a normal standing position. A specially built strain gauged type pressure transducer was used for measuring pressure distribution. Pressure and gait parameters were measured simultaneously while the subjects were standing and walking.
The pressure cast technique was able to provide comfortable fitting sockets. A hydrostatic pressure profile was not evident during standing or gait. Results also showed that no standard pressure profile for the pressure cast socket was observed. This was expected as no rectifications were done on the pressure cast socket. Pressure profiles at 10%, 25% and 50% of gait cycle did not correlate with the pressure profiles previously proposed.
The hydrostatic theory is an attractive concept in socket design as it produces a stump/socket pressure profile that is evenly distributed. Furthermore, it is a method that is easily implemented, independent of a prosthetist's skill and experience and reduces manufacturing time. However, there is still controversy surrounding the efficacy of this hydrostatic theory.
评估佩戴由压力铸造系统开发的接受腔的截肢者残肢/接受腔界面压力。设计:五名单侧胫骨截肢者佩戴压力铸造接受腔并以自选速度行走。
该接受腔在残肢/接受腔界面产生均匀分布的压力,这与传统观念不同,传统观念认为压力与残肢中不同组织的疼痛阈值成比例变化。
在受试者将残肢置于压力室时制作接受腔。在他采取正常站立姿势时施加压力。使用专门制造的应变片式压力传感器测量压力分布。在受试者站立和行走时同时测量压力和步态参数。
压力铸造技术能够提供舒适贴合的接受腔。站立或步态期间未观察到静水压力分布。结果还表明,未观察到压力铸造接受腔的标准压力分布。由于未对压力铸造接受腔进行校正,这是意料之中的。步态周期的10%、25%和50%时的压力分布与先前提出的压力分布不相关。
静水理论在接受腔设计中是一个有吸引力的概念,因为它产生均匀分布的残肢/接受腔压力分布。此外,它是一种易于实施的方法,不依赖于假肢技师的技能和经验,并减少制造时间。然而,围绕这种静水理论的有效性仍存在争议。