Agrawal Vibhor, Gailey Robert S, Gaunaurd Ignacio A, O'Toole Christopher, Finnieston Adam, Tolchin Ronald
Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, USA Research Department, Miami Veterans Affairs Healthcare System, Miami, USA
Department of Physical Therapy, Miller School of Medicine, University of Miami, Coral Gables, USA Research Department, Miami Veterans Affairs Healthcare System, Miami, USA.
Prosthet Orthot Int. 2015 Oct;39(5):380-9. doi: 10.1177/0309364614536762. Epub 2014 Jun 12.
Comparative effectiveness of prosthetic feet during ramp ambulation in unilateral transtibial amputees, who function at different Medicare Functional Classification Levels, has not been published.
To determine differences in symmetry in external work between four categories of prosthetic feet in K-Level-2 and K-Level-3 unilateral transtibial amputees during ramp ascent and descent.
Randomized repeated-measures trial.
Ten subjects completed six testing sessions during which symmetry in external work was calculated using F-scan in-sole sensors. Between testing sessions 1 and 2, subjects received standardized functional prosthetic training. In Sessions 3-6, subjects tested four feet--solid ankle cushion heel, stationary attachment flexible endoskeleton, Talux (categories K1, K2, and K3, respectively), and Proprio-Foot (microprocessor ankle)--using a study socket and had a 10- to 14-day accommodation period with each foot.
During ramp descent, K-Level-2 subjects demonstrated higher symmetry in external work values with Talux and Proprio-Foot compared to the solid ankle cushion heel foot. K-Level-3 subjects also had higher symmetry in external work values with the Talux foot than the solid ankle cushion heel foot. Ramp ascent symmetry in external work values were not significantly different between feet.
Prosthetic foot category appears to influence symmetry in external work more during decline walking than incline walking. K-Level-2 unilateral transtibial amputees achieve greater symmetry from K3 dynamic response prosthetic feet with J-shaped ankle and microprocessor ankles while descending ramps.
The findings suggest that K-Level-2 unilateral transtibial amputees benefit from K3 dynamic response prosthetic feet with J-shaped ankle. These results support the prescription of K3 feet for K-Level-2 amputees who frequently negotiate ramps.
对于处于不同医疗保险功能分级水平的单侧经胫骨截肢者，在斜坡行走过程中不同假脚的比较有效性尚未见报道。
确定K级2和K级3单侧经胫骨截肢者在斜坡上升和下降过程中四类假脚的外部功对称性差异。
随机重复测量试验。
10名受试者完成6次测试，期间使用F-scan鞋垫式传感器计算外部功的对称性。在测试1和测试2之间，受试者接受标准化功能假肢训练。在测试3 - 6中，受试者使用研究用接受腔测试四种假脚——实心踝垫跟假脚、固定连接柔性内骨骼假脚、Talux假脚（分别对应K1、K2和K3类别）以及本体感觉脚假脚（微处理器踝关节假脚），每只假脚有10至14天的适应期。
在斜坡下降过程中，与实心踝垫跟假脚相比，K级2受试者使用Talux假脚和本体感觉脚假脚时外部功值的对称性更高。K级3受试者使用Talux假脚时外部功值的对称性也高于实心踝垫跟假脚。不同假脚在斜坡上升时外部功值的对称性无显著差异。
假脚类别在下行行走过程中似乎比上行行走过程中对外部功对称性的影响更大。K级2单侧经胫骨截肢者在斜坡下降时使用具有J形踝关节和微处理器踝关节的K3动态响应假脚可获得更大的对称性。
研究结果表明，K级2单侧经胫骨截肢者受益于具有J形踝关节的K3动态响应假脚。这些结果支持为经常通过斜坡的K级2截肢者开具K3假脚的处方。
