Barnett Cleveland, Vanicek Natalie, Polman Remco, Hancock Amanda, Brown Barbara, Smith Lynne, Chetter Ian
Department of Sport, Health and Exercise Science, University of Hull.
Prosthet Orthot Int. 2009 Jun;33(2):135-47. doi: 10.1080/03093640902751762.
Physiotherapists routinely prescribe the use of two different early walking aids (EWAs) to individuals who have recently undergone unilateral transtibial amputation. No research to date has investigated the kinematic gait patterns of transtibial amputees walking with an EWA during early rehabilitation. The aim of the current RCT study was to compare gait patterns when walking with two different EWAs and whether either EWA provided patients with greater gait benefits.
Patients were randomly assigned into one of two EWA groups, one group using the Amputee Mobility Aid and another using the Pneumatic Post-Amputation Aid, prior to receiving their functional prosthesis. A 3D motion capture system recorded kinematic data from their first steps up to discharge from rehabilitation.
Walking velocity increased significantly (p < 0.01) during rehabilitation. Control of the prosthetic knee improved during rehabilitation in both groups. A lack of conclusive differences between EWAs was noted at discharge from rehabilitation.
Both groups displayed changes in gait patterns in different gait measures during rehabilitation. However, these changes were not the same for both groups. Gait adaptations occurred soon after walking with a functional prosthesis.
The results from this study would suggest that neither EWA was more beneficial for gait retraining during rehabilitation.
物理治疗师通常会给近期接受单侧胫骨截肢的患者开两种不同的早期步行辅助器具(EWA)。迄今为止,尚无研究调查过胫骨截肢者在早期康复期间使用EWA行走时的运动步态模式。当前这项随机对照试验(RCT)研究的目的是比较使用两种不同EWA行走时的步态模式,以及是否有任何一种EWA能为患者带来更大的步态改善。
在患者接受功能性假肢之前,将他们随机分为两个EWA组之一,一组使用截肢者移动辅助器具,另一组使用气动截肢后辅助器具。一个三维运动捕捉系统记录了他们从迈出第一步到康复出院期间的运动学数据。
康复期间步行速度显著提高(p < 0.01)。两组患者在康复期间对假肢膝关节的控制均有所改善。在康复出院时,未发现EWA之间存在决定性差异。
两组在康复期间不同步态测量中的步态模式均有变化。然而,两组的这些变化并不相同。使用功能性假肢行走后不久就出现了步态适应性变化。
这项研究的结果表明,在康复期间,两种EWA对步态再训练都没有更明显的益处。