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经胫截肢者在直线行走以及一项常见转弯任务中,使用和不使用扭转适配器时的关节旋转力矩。

Transtibial amputee joint rotation moments during straight-line walking and a common turning task with and without a torsion adapter.

作者信息

Segal Ava D, Orendurff Michael S, Czerniecki Joseph M, Shofer Jane B, Klute Glenn K

机构信息

Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Rehabilitation Research and Development Service, Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.

出版信息

J Rehabil Res Dev. 2009;46(3):375-83.

Abstract

Amputees lack movement and control mechanisms at the foot and ankle that result in different strategies for locomotion than nonamputees. The torsion adapter is a prosthetic device designed to minimize shear stress at the residual limb by facilitating rotation in the transverse plane. This study determined if the addition of a torsion adapter alters lower-limb joint rotation moments of transtibial amputees walking in a straight line and turning. Ten transtibial amputees wore either a torsion adapter or a rigid adapter for an acclimation period of 3 weeks in random order. Ten nonamputees were also included for comparison. Kinetics were collected as participants walked in a straight line and around a 1 m-radius circular path at their self-selected turning walking speed. When amputee participants wore the torsion adapter, they demonstrated decreased prosthetic-limb peak internal rotation moments at the inside limb knee and hip compared with when they wore the rigid adapter, which may facilitate changes in orientation by not actively resisting the turn. Nonamputees exhibited larger moments compared with the prosthetic limb for both the amputee participants wearing either the torsion or rigid adapters. No differences were found in the moments for the intact limb between torsion and rigid adapter conditions during turning and for both limbs during straight-line walking.

摘要

截肢者在足部和脚踝缺乏运动及控制机制,这导致他们的行走策略与非截肢者不同。扭转适配器是一种假肢装置,旨在通过促进横向平面内的旋转来最小化残肢处的剪切应力。本研究确定添加扭转适配器是否会改变经胫截肢者直线行走和转弯时下肢关节的旋转力矩。十名经胫截肢者以随机顺序佩戴扭转适配器或刚性适配器,适应期为3周。还纳入了十名非截肢者作为对照。在参与者以自行选择的转弯行走速度沿直线行走并绕半径为1米的圆形路径行走时收集动力学数据。当截肢参与者佩戴扭转适配器时,与佩戴刚性适配器相比,他们在内侧肢体的膝盖和臀部处的假肢肢体峰值内旋力矩有所降低,这可能通过不主动抵抗转弯来促进方向改变。与佩戴扭转或刚性适配器的截肢参与者的假肢肢体相比,非截肢者表现出更大的力矩。在转弯过程中,扭转和刚性适配器条件下的完整肢体力矩以及直线行走过程中双下肢的力矩均未发现差异。

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