Karimi Mohammad Taghi, Esrafilian Omid, Esrafilian Amir, Sadigh Mohammad Jafar, Amiri Pouya
Orthotics and Prosthetics, Musculoskeletal Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran.
Clin Biomech (Bristol). 2013 Mar;28(3):325-9. doi: 10.1016/j.clinbiomech.2013.01.001. Epub 2013 Jan 27.
Spinal cord injury is a damage to spinal cord that results in loss of function and mobility below the level of injury. The patients use various orthoses to improve their general health, to decrease bone osteoporosis, and to improve bone mineral density. It was controversial if how much percentage of the loads applied on an orthosis and body complex is transmitted by orthosis. Therefore, it was aimed to determine the magnitude of the loads transmitted by orthosis to find the influence of walking with orthosis on bone mineral density.
Three spinal cord injured subjects were recruited in this study. They were trained to walk with a reciprocal gait orthosis. The loads applied on the hip joint of the orthosis and body complex, anatomy and orthosis were measured by use of strain gauges and motion analysis system.
The mean values of the force and moments transmitted by the orthosis were significantly less than those of the complex. The mean values of adduction moment transmitted through the orthosis and body complex and by the orthosis structure were 1.06 and 0.49N·m/body weight, respectively.
As a higher percentage of loads were transmitted by body than the orthosis, it can be concluded that walking with orthosis could improve bone mineral density, due to the role of bone in transmission of the loads. Therefore, it is recommended that spinal cord injured subjects walk with an orthosis in order to reduce bone osteoporosis, especially for a long period of time.
脊髓损伤是指脊髓受到损伤，导致损伤平面以下功能丧失和活动能力受限。患者使用各种矫形器来改善整体健康状况，减少骨质疏松，并提高骨矿物质密度。矫形器和身体复合体所承受的负荷中有多大比例是通过矫形器传递的，这一点存在争议。因此，本研究旨在确定矫形器传递的负荷大小，以探究使用矫形器行走对骨矿物质密度的影响。
本研究招募了三名脊髓损伤受试者。他们接受了使用往复式步态矫形器行走的训练。通过应变片和运动分析系统测量施加在矫形器与身体复合体、解剖结构及矫形器髋关节上的负荷。
矫形器传递的力和力矩的平均值显著低于身体复合体传递的力和力矩的平均值。通过矫形器与身体复合体以及矫形器结构传递的内收力矩的平均值分别为1.06和0.49N·m/体重。
由于身体传递的负荷比例高于矫形器，因此可以得出结论，使用矫形器行走可改善骨矿物质密度，这是因为骨骼在负荷传递中发挥了作用。因此，建议脊髓损伤患者使用矫形器行走，以减少骨质疏松，尤其是长期使用。
