Functional Outcomes Research & Evaluation Center (FORE Center), Miami Veterans Affairs Medical Center, Miami, FL, USA.
Ergonomics. 2011 Jul;54(7):656-64. doi: 10.1080/00140139.2011.586060.
This study characterises weight distribution symmetry between the intact and amputated limbs of unilateral transtibial amputees during a sit-to-stand movement. A total of 12 amputees and 12 age-matched, non-amputees performed the activity for two conditions - rising with and without chair arm-rest assistance. The sit-to-stand movement was divided into five events: Pre-Ascent; Ascent Initiation; Seat-Off; Deceleration; Standing. Symmetry in ground reaction forces between limbs was calculated at each event together with the rise time. Results indicate that during the course of the movement, amputees increased loading of the intact limb by approximately 27%, resulting in a significant asymmetry at seat-off and deceleration events. Non-amputees loaded the dominant limb more than the non-dominant limb throughout the activity but did not exhibit substantial weight shifts. Weight distribution symmetry was not significantly different between the two rising conditions in either population. Amputees had significantly longer rise times than non-amputees only while rising without arm-rest assistance. STATEMENT OF RELEVANCE: Sit-to-stand movements are performed frequently every day. Incorrect movement biomechanics caused by musculoskeletal impairments can lead to reduced functional independence and secondary co-morbidities. This study defines five events of a sit-to-stand cycle and is the first to address asymmetries of transtibial amputees, providing ergonomic insights for clinical assessment and intervention.
本研究描述了单侧小腿截肢患者在从坐姿到站姿的运动过程中,未截肢侧和截肢侧肢体之间的重量分布对称性。共有 12 名截肢者和 12 名年龄匹配的非截肢者进行了两种情况的活动——有和没有椅子扶手辅助的情况下起身。坐姿到站姿的运动分为五个事件:预上升;上升启动;坐下离开;减速;站立。在每个事件中,计算了肢体之间的地面反作用力对称性以及上升时间。结果表明,在运动过程中,截肢者通过大约 27%的方式增加了未截肢侧肢体的负荷,从而导致在坐下离开和减速事件中出现明显的不对称。非截肢者在整个活动中对优势肢体的负荷超过了非优势肢体,但没有表现出明显的体重转移。在两种上升情况下,两个群体的体重分布对称性没有显著差异。只有在没有扶手辅助的情况下,截肢者的上升时间明显长于非截肢者。
从坐姿到站姿的动作每天都会频繁进行。由于肌肉骨骼损伤引起的不正确运动生物力学可能导致功能独立性降低和继发性合并症。本研究定义了坐姿到站姿周期的五个事件,首次解决了小腿截肢者的不对称问题,为临床评估和干预提供了人体工程学见解。