Kobayashi Toshiki, Orendurff Michael S, Zhang Ming, Boone David A
Orthocare Innovations, Mountlake Terrace, WA, USA.
Orthocare Innovations, Mountlake Terrace, WA, USA.
Clin Biomech (Bristol). 2014 May;29(5):590-4. doi: 10.1016/j.clinbiomech.2014.04.002. Epub 2014 Apr 16.
The alignment of transtibial prostheses has a systematic effect on the mean socket reaction moments in amputees. However, understanding their individual differences in response to alignment perturbations is also important for prosthetists to fully utilize the socket reaction moments for dynamic alignment in each unique patient. The aim of this study was to investigate individual responses to alignment perturbations in transtibial prostheses with solid-ankle-cushion-heel feet.
A custom instrumented prosthesis alignment component was used to measure the socket reaction moments while walking in 11 amputees with transtibial prostheses under 17 alignment conditions, including 3° and 6° of flexion, extension, abduction, and adduction of the socket, 5mm and 10mm of anterior, posterior, lateral, and medial translation of the socket, and an initial baseline alignment. Coronal moments at 30% of stance and maximum sagittal moments were extracted for comparisons from each amputee.
In the coronal plane, varus moment at 30% of stance was generally reduced by adduction or medial translation of the socket in all the amputees. In the sagittal plane, extension moment was generally increased by posterior translation or flexion of the socket; however, this was not necessarily the case for all the amputees.
Individual responses to alignment perturbations are not always consistent, and prosthetists would need to be aware of this variance when addressing individual socket reaction moments during dynamic alignment in clinical setting.
经胫假肢的对线对截肢者的平均接受腔反应力矩有系统性影响。然而，了解他们对假肢对线扰动的个体差异，对于假肢师在每个独特患者中充分利用接受腔反应力矩进行动态对线也很重要。本研究的目的是调查使用实心踝垫跟脚的经胫假肢对假肢对线扰动的个体反应。
使用定制的带有仪器的假肢对线组件，在11名佩戴经胫假肢的截肢者于17种对线条件下行走时测量接受腔反应力矩，这些条件包括接受腔3°和6°的屈曲、伸展、外展和内收，接受腔5毫米和10毫米的前向、后向、侧向和内侧平移，以及初始基线对线。从每个截肢者中提取站立30%时的冠状面力矩和最大矢状面力矩进行比较。
在冠状面，所有截肢者中，接受腔内收或内侧平移通常会使站立30%时的内翻力矩减小。在矢状面，接受腔后向平移或屈曲通常会使伸展力矩增加；然而，并非所有截肢者都是如此。
个体对假肢对线扰动的反应并不总是一致的，假肢师在临床环境中进行动态对线时处理个体接受腔反应力矩时需要意识到这种差异。
