Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
Disabil Rehabil. 2013 Jun;35(11):888-93. doi: 10.3109/09638288.2012.712197. Epub 2012 Sep 20.
Many trans-tibial amputees could not tolerate long-distance walking. Lack of walking could explain for the increased cardiovascular diseases mortality rate. This study investigated the effects of long-distance walking (LDW) on socket-limb interface pressure, tactile sensitivity of the residual limb, and subjective feedbacks, which potentially identified the difficulties in LDW.
Five male unilateral trans-tibial amputees walked on a level treadmill for a total of one hour at comfortable speed. Tactile sensitivity of the residual limb and socket-limb interface pressure during over-ground walking were measured before and after the treadmill walking. Modified Prosthesis Evaluation Questionnaires were also administered.
After the treadmill walking, the socket-limb interface pressure and the tactile sensitivity at the popliteal depression area were significantly reduced. This corresponds well with the questionnaire results showing that the level of discomfort and pain of the residual limb did not increase. The questionnaire revealed that there were significant increases in fatigue level at the sound-side plantar flexors, which could lead to impaired dynamic stability.
Fatigue of sound-side plantar-flexor was the main difficulty faced by the five subjects when walking long-distances. This finding might imply the importance of refining prosthetic components and rehabilitation protocols in reducing the muscle fatigue.
• After long-distance walking (LDW) of the trans-tibal amputee subjects, there were significant increases in fatigue level at the plantar flexors. These might explain the reduced walking stability as perceived by the subjects. • LDW did not produce any problems in residual-limb comfort and pain feeling. These were in line with the significant reductions of socket-limb interface pressure and the tactile sensitivity at the popliteal depression after LDW. • Refinements of prosthetic components and rehabilitation protocols should be attempted to reduce the fatigue of the plantar flexors and facilitate LDW.
许多胫骨截肢者无法耐受长距离行走。缺乏行走可能导致心血管疾病死亡率的增加。本研究旨在探讨长距离行走（LDW）对义肢-接受腔界面压力、残肢触觉敏感性和主观反馈的影响，这些因素可能会影响LDW。
5 名男性单侧胫骨截肢者在舒适速度下在水平跑步机上行走 1 小时。在跑步机行走前后，测量了残肢和地面行走时的接受腔-肢体界面压力以及残肢的触觉敏感性。还使用了改良的义肢评估问卷。
跑步机行走后，接受腔-肢体界面压力和腘窝区域的触觉敏感性显著降低。这与问卷结果一致，表明残肢的不适和疼痛程度没有增加。问卷显示，健侧足底屈肌的疲劳水平显著增加，这可能导致动态稳定性受损。
疲劳是 5 名受试者长距离行走时面临的主要困难。这一发现可能意味着，在减少肌肉疲劳方面，改进假肢部件和康复方案非常重要。
胫骨截肢者受试者进行长距离行走（LDW）后，足底屈肌的疲劳水平显著增加。这些可能解释了受试者感知到的行走稳定性降低的原因。
LDW 并未导致残肢舒适度和疼痛感觉出现任何问题。这与 LDW 后接受腔-肢体界面压力和腘窝处触觉敏感性的显著降低一致。
应尝试改进假肢部件和康复方案，以减少足底屈肌的疲劳，并促进 LDW。
