Howcroft Jennifer, Lemaire Edward D, Kofman Jonathan, Kendell Cynthia
Department of Systems Design Engineering, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1.
Ottawa Hospital Research Institute, Centre for Rehabilitation, Research and Development, 505 Smyth Road, Ottawa, Ontario, Canada K1H 8M2; University of Ottawa, Faculty of Medicine, 451 Smyth Road, Ottawa, Ontario, Canada K1H 8M5.
Gait Posture. 2015 Mar;41(3):808-12. doi: 10.1016/j.gaitpost.2015.03.001. Epub 2015 Mar 7.
This study investigated whether pelvis acceleration-derived parameters can differentiate between dynamic stability states for transtibial amputees during level (LG) and uneven ground (UG) walking. Correlations between these parameters and clinical balance and mobility measures were also investigated. A convenience sample of eleven individuals with unilateral transtibial amputation walked on LG and simulated UG while pelvis acceleration data were collected at 100Hz. Descriptive statistics, Fast Fourier Transform, ratio of even to odd harmonics, and maximum Lyapunov exponent measures were derived from acceleration data. Of the 26 pelvis acceleration measures, seven had a significant difference (p≤0.05) between LG and UG walking conditions. Seven distinct, stability-relevant measures appeared in at least one of the six regression models that correlated accelerometer-derived measures to Berg Balance Scale (BBS), Community Balance and Mobility Scale (CBMS), and Prosthesis Evaluation Questionnaire (PEQ) scores, explaining up to 100% of the variability in these measures. Of these seven measures, medial-lateral acceleration range was the most frequent model variable, appearing in four models. Anterior-posterior acceleration standard deviation and stride time appeared in three models. Pelvis acceleration-derived parameters were able to differentiate between LG and UG walking for transtibial amputees. UG walking provided the most relevant data for balance and mobility assessment. These results could translate to point of patient contact assessments using a wearable system such as a smartbelt or accelerometer-equipped smartphone.
本研究调查了经胫骨截肢者在平路（LG）和不平地面（UG）行走时，骨盆加速度衍生参数能否区分动态稳定状态。还研究了这些参数与临床平衡和移动性测量之间的相关性。11名单侧经胫骨截肢者的便利样本在平路和模拟不平地面上行走，同时以100Hz的频率收集骨盆加速度数据。从加速度数据中得出描述性统计、快速傅里叶变换、偶次谐波与奇次谐波的比率以及最大Lyapunov指数测量值。在26项骨盆加速度测量中，有7项在平路和不平地面行走条件之间存在显著差异（p≤0.05）。在将加速度计衍生测量值与伯格平衡量表（BBS）、社区平衡与移动性量表（CBMS）以及假体评估问卷（PEQ）得分相关联的六个回归模型中的至少一个中，出现了七个不同的、与稳定性相关的测量值，解释了这些测量值中高达100%的变异性。在这七个测量值中，内外侧加速度范围是最常出现的模型变量，出现在四个模型中。前后加速度标准差和步幅时间出现在三个模型中。经胫骨截肢者的骨盆加速度衍生参数能够区分平路和不平地面行走。不平地面行走为平衡和移动性评估提供了最相关的数据。这些结果可以转化为使用可穿戴系统（如智能腰带或配备加速度计的智能手机）进行患者接触点评估。
