Sánchez Natalia, Acosta Ana Maria, Stienen Arno H A, Dewald Julius P A
IEEE Trans Neural Syst Rehabil Eng. 2015 Sep;23(5):765-75. doi: 10.1109/TNSRE.2014.2348801. Epub 2014 Aug 21.
Characterization of the joint torque coupling strategies used in the lower extremity to generate maximal and submaximal levels of torque at either the hip, knee, or ankle is lacking. Currently, there are no available isometric devices that quantify all concurrent joint torques in the hip, knee, and ankle of a single leg during maximum voluntary torque generation. Thus, joint-torque coupling strategies in the hip, knee, and concurrent torques at ankle and/or coupling patterns at the hip and knee driven by the ankle have yet to be quantified. This manuscript describes the design, implementation, and validation of a multiple degree of freedom, lower extremity isometric device (the MultiLEIT) that accurately quantifies simultaneous torques at the hip, knee, and ankle. The system was mechanically validated and then implemented with two healthy control individuals and two post-stroke individuals to test usability and patient acceptance. Data indicated different joint torque coupling strategies used by both healthy individuals. In contrast, data showed the same torque coupling patterns in both post-stroke individuals, comparable to those described in the clinic. Successful implementation of the MultiLEIT can contribute to the understanding of the underlying mechanisms responsible for abnormal movement patterns and aid in the design of therapeutic interventions.
目前尚缺乏对下肢用于在髋关节、膝关节或踝关节产生最大和次最大扭矩水平时所采用的关节扭矩耦合策略的描述。当前,没有可用的等长测力装置能够在最大自主扭矩产生期间量化单腿髋关节、膝关节和踝关节的所有同时出现的关节扭矩。因此,髋关节、膝关节的关节扭矩耦合策略以及由踝关节驱动的踝关节同时扭矩和/或髋关节与膝关节的耦合模式尚未得到量化。本手稿描述了一种多自由度下肢等长测力装置(MultiLEIT)的设计、实施和验证,该装置能够准确量化髋关节、膝关节和踝关节的同步扭矩。该系统经过了机械验证,然后应用于两名健康对照个体和两名中风后个体,以测试其可用性和患者接受度。数据表明健康个体使用了不同的关节扭矩耦合策略。相比之下,数据显示中风后个体的扭矩耦合模式相同,与临床描述的模式相当。MultiLEIT的成功应用有助于理解导致异常运动模式的潜在机制,并有助于设计治疗干预措施。