Castro Marcelo Peduzzi de, Soares Denise, Mendes Emília, Machado Leandro
Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal; Porto Biomechanics Laboratory, University of Porto, Rua Dr. Plácido Costa, 91 - 4200.450, Porto, Portugal(∗).
Center of Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, Porto, Portugal; Porto Biomechanics Laboratory, University of Porto, Porto, Portugal(†).
PM R. 2014 Aug;6(8):698-707.e1. doi: 10.1016/j.pmrj.2014.01.019. Epub 2014 Jan 29.
To describe and compare the plantar pressures, temporal foot roll-over, and ground reaction forces (GRFs) between both limbs of subjects with unilateral transfemoral amputation and with those of able-bodied participants during walking. We also verify the relevance of a force plate and a pressure plate to discriminate changes in gait parameters of subjects with limb loss.
Cross-sectional study.
Biomechanics laboratory.
A total of 14 subjects with unilateral transfemoral amputation and 21 able-bodied participants.
We used a force plate and a pressure plate to assess biomechanical gait parameters while the participants were walking at their self-selected gait speed.
We measured plantar pressure peaks in 6 foot regions and the instant of their occurrence (temporal foot roll-over); and GRF peaks and impulses of anterior-posterior (braking and propulsive phases), medial-lateral, and vertical (load acceptance and thrust phases) components.
The thrust, braking, and propulsive peaks, and the braking and propulsive impulses, were statistically significantly lower in the amputated limb than in the sound limb (P < .05) and in able-bodied participants (P < .05). In the amputated limb, we observed higher pressure peaks in the lateral rearfoot and medial and lateral midfoot, and lower values in the forefoot regions compared to those in the other groups (P < .05). The temporal foot roll-over showed statistically significant differences among the groups (P < .05).
The plantar pressures, temporal foot roll-over, and GRFs in subjects with unilateral transfemoral amputation showed an asymmetric gait pattern, and different values were observed in both of their lower limbs as compared with those of able-bodied subjects during walking. The force plate and pressure plate were able to determine differences between participants in gait pattern, suggesting that both plantar pressure and GRF analyses are useful tools for gait assessment in individuals with unilateral transfemoral amputation. Because of the convenience of pressure plates, their use in the clinical context for prosthetic management appears relevant to guide the rehabilitation of subjects with lower limb amputation.
描述并比较单侧经股骨截肢患者双下肢与健全参与者在行走过程中的足底压力、足部滚动时间以及地面反作用力（GRF）。我们还验证了测力板和压力板在区分肢体缺失患者步态参数变化方面的相关性。
横断面研究。
生物力学实验室。
共14名单侧经股骨截肢患者和21名健全参与者。
当参与者以自行选择的步态速度行走时，我们使用测力板和压力板来评估生物力学步态参数。
我们测量了6个足部区域的足底压力峰值及其出现时刻（足部滚动时间）；以及GRF峰值和前后方向（制动和推进阶段）、内外侧和垂直方向（负荷接受和推力阶段）分量的冲量。
截肢侧的推力、制动和推进峰值以及制动和推进冲量在统计学上显著低于健全侧（P <.05）和健全参与者（P <.05）。在截肢侧，与其他组相比，我们观察到后足外侧、中足内侧和外侧的压力峰值较高，而前足区域的值较低（P <.05）。足部滚动时间在各组之间存在统计学显著差异（P <.05）。
单侧经股骨截肢患者的足底压力、足部滚动时间和GRF呈现出不对称的步态模式，与健全受试者相比，其双下肢在行走过程中观察到不同的值。测力板和压力板能够确定参与者在步态模式上的差异，这表明足底压力分析和GRF分析都是评估单侧经股骨截肢个体步态的有用工具。由于压力板使用方便，其在临床环境中用于假肢管理似乎与指导下肢截肢患者康复相关。
