Starholm Inger-Marie, Gjovaag Terje, Mengshoel Anne Marit
Department of Health Sciences, Oslo College University, Prosthetic and Orthotic Programme, Oslo, Norway.
Prosthet Orthot Int. 2010 Jun;34(2):184-94. doi: 10.3109/03093640903585016.
Transfemoral amputees often report that walking on tilted pavements or on terrain with the prosthesis on the side of higher elevation is quite strenuous. This study investigates the energy expenditure of transfemoral amputees (n = 8) on a motorized treadmill, simulating different strenuous outdoor walking conditions. Oxygen uptake at self-selected speed of gait was measured during walking at three different treadmill positions: (i) Horizontal treadmill, (ii) 3% tilt in the sagittal plane and (iii) 3% tilt in both the sagittal and frontal plane of the treadmill. The difference in median values of oxygen uptake between position (i) and (ii) was 4.3%, and 16.4% between position (ii) and (iii) (p < or = 0.05, for both comparisons). The subjects utilized about 50% of their VO(2max) when walking in position (i) and (ii), with an increase to about 60% of their VO(2max) when walking in position (iii). Transfemoral amputees use significantly more energy when walking on a moderately tilted surface in the frontal plane compared to walking with a tilt in the sagittal plane. This is probably because the prosthetic leg becomes functionally too long when the walking surface is tilted sideways, and the transfemoral amputees adopt a more energy consuming gait pattern.
经股截肢者常称，在倾斜路面或较高一侧装有假肢的地形上行走十分费力。本研究调查了8名经股截肢者在电动跑步机上模拟不同费力户外行走条件时的能量消耗情况。在跑步机的三个不同位置行走时，测量了自定步态速度下的摄氧量：(i) 水平跑步机，(ii) 矢状面3%倾斜，(iii) 跑步机矢状面和额状面均3%倾斜。位置(i)和(ii)之间摄氧量中位数的差异为4.3%，位置(ii)和(iii)之间为16.4%（两种比较的p值均≤0.05）。受试者在位置(i)和(ii)行走时，约使用其最大摄氧量(VO₂max)的50%，在位置(iii)行走时则增至约60%。与在矢状面倾斜的情况下行走相比，经股截肢者在额状面适度倾斜的表面上行走时消耗的能量明显更多。这可能是因为当行走表面向一侧倾斜时，假肢腿在功能上变得过长，经股截肢者会采用更耗能的步态模式。
