Chin Takaaki, Oyabu Hiroko, Maeda Yoshiaki, Takase Izumi, Machida Katsuhiro
Hyogo Rehabilitation Center, Kobe, Japan.
Am J Phys Med Rehabil. 2009 May;88(5):399-403. doi: 10.1097/PHM.0b013e3181a0dbe2.
To investigate the differences in energy consumption by patients with hip disarticulation between prosthetic walking and wheelchair locomotion.
: The subjects consisted of seven amputees, all older than 60, with unilateral hip disarticulation. Energy consumption when walking with prosthesis and when propelling a wheelchair, each at the respective comfortable movement speed, was measured by means of a portable telemetric system.
The average comfortable movement speed for prosthetic walking was 30.5 m/min, which was much slower than the 63.1 m/min average for wheelchair locomotion (P < 0.01). The average oxygen cost value for prosthetic walking was 0.639 ml/kg/m, and the average for wheelchair locomotion was 0.175 ml/kg/m, indicating that oxygen cost was significantly higher for prosthetic walking than for wheelchair locomotion (P < 0.01).
The results of this research clearly showed that the efficiency of prosthetic walking for elderly hip disarticulation amputees was very low. When the subject is judged not to be a candidate for practical prosthetic walking after a careful multidisciplinary evaluation, wheelchair locomotion may be an alternative to prosthetic walking as a realistic goal.
研究髋关节离断患者在使用假肢行走和使用轮椅移动时的能量消耗差异。
研究对象包括7名年龄均超过60岁的单侧髋关节离断截肢者。通过便携式遥测系统测量他们分别以各自舒适的移动速度使用假肢行走和推动轮椅时的能量消耗。
使用假肢行走时的平均舒适移动速度为30.5米/分钟，远低于使用轮椅移动时63.1米/分钟的平均速度（P<0.01）。使用假肢行走时的平均耗氧量为0.639毫升/千克/米，使用轮椅移动时为0.175毫升/千克/米，这表明使用假肢行走时的耗氧量显著高于使用轮椅移动时（P<0.01）。
本研究结果清楚表明，老年髋关节离断截肢者使用假肢行走的效率非常低。经过仔细的多学科评估，如果判定患者不适合实际使用假肢行走，那么轮椅移动可能是替代假肢行走的一个现实可行的目标。
