Ramstrand Nerrolyn, Nilsson Kjell-Ake
Department of Rehabilitation, Jönköping University, Jönköping, Sweden.
Prosthet Orthot Int. 2009 Dec;33(4):348-55. doi: 10.3109/03093640903074891.
Ambulation on stairs presents a significant challenge for lower extremity amputees and increases the risk of falling and sustaining a serious injury. This study aimed to compare foot placement and foot clearance during stair ambulation in a group of transtibial amputees and a group of able-bodied subjects. Three-dimensional motion analysis was used to determine foot positioning and to calculate temporospatial parameters during stair ascent and descent of 10 transtibial amputees (mean age = 56) and a control group consisting of 10 healthy able-bodied individuals (mean age = 26.7). No significant difference was observed in foot positioning and foot clearance between the amputee and control groups. Temporospatial data revealed a number of significant differences between the groups, particularly during stair ascent. Amputees were observed to walk with a slower velocity and cadence (p < 0.01), to increase the time spent in stance phase and double support (p < 0.01) and to increase their step width during both stair ascent and descent (p < 0.01). Results suggest that foot placement and clearance are not factors that would contribute to a stumble or fall on stairs in established amputees but that balance related issues, such as relative motion of the centre of mass, require further investigation.
对于下肢截肢者而言,上下楼梯是一项重大挑战,且会增加摔倒及遭受重伤的风险。本研究旨在比较一组经胫骨截肢者与一组健全受试者在上下楼梯过程中的足部放置和足部净空情况。采用三维运动分析来确定足部位置,并计算10名经胫骨截肢者(平均年龄 = 56岁)以及由10名健康健全个体组成的对照组(平均年龄 = 26.7岁)在上下楼梯时的时空参数。截肢组与对照组在足部位置和足部净空方面未观察到显著差异。时空数据显示两组之间存在一些显著差异,尤其是在楼梯上升过程中。观察到截肢者行走速度和步频较慢(p < 0.01),站立期和双支撑期时间增加(p < 0.01),并且在上下楼梯时步幅均增大(p < 0.01)。结果表明,足部放置和净空并非导致成熟截肢者在楼梯上绊倒或摔倒的因素,但与平衡相关的问题,如重心的相对运动,需要进一步研究。