Demšar Ivan, Duhovnik Jože, Lešnik Blaž, Supej Matej
Laboratory for Computer-Aided Design, Faculty of Mechanical Engineering, University of Ljubljana , Ljubljana, Slovenia.
Department of Alpine skiing, Faculty of Sport, University of Ljubljana , Ljubljana, Slovenia.
J Sports Sci Med. 2015 Nov 24;14(4):841-8. eCollection 2015 Dec.
The purpose of the study was to analyse the flexion angles of the ski boot, ankle and knee joints of an above-knee prosthesis and to compare them with an intact leg and a control group of skiers. One subject with an above-knee amputation of the right leg and eight healthy subjects simulated the movement of a skiing turn by performing two-leg squats in laboratory conditions. By adding additional loads in proportion to body weight (BW; +1/3 BW, +2/3 BW, +3/3 BW), various skiing regimes were simulated. Change of Flexion Angle (CoFA) and Range of Motion (RoM) in the ski boot, ankle and knee joints were calculated and compared. An average RoM in the skiing boot on the side of prosthesis (4.4 ± 1.1°) was significantly lower compared to an intact leg (5.9 ± 1.8°) and the control group (6.5 ± 2.3°). In the ankle joint, the average RoM was determined to be 13.2±2.9° in the prosthesis, 12.7 ± 2.8° in an intact leg and 14.8±3.6 in the control group. However, the RoM of the knee joint in the prosthesis (42.2 ± 4.2°) was significantly larger than that of the intact leg (34.7 ± 4.4°). The average RoM of the knee joint in the control group was 47.8 ± 5.4°. The influences of additional loads on the kinematics of the lower extremities were different on the side of the prosthesis and on the intact leg. In contrast, additional loads did not produce any significant differences in the control group. Although different CoFAs in the ski boot, ankle and knee joints were used, an above-knee prosthesis with a built-in multi-axis prosthetic knee enables comparable leg kinematics in simulated alpine skiing. Key pointsThe RoM in the ski boot on the side of the prosthetic leg was smaller than the RoM of the intact leg and the control group of healthy subjects.The RoM in the ankle joint of prosthetic leg was comparable to that of the intact leg and the control group of healthy subjects.The RoM in the prosthetic knee joint was greater than the RoM in the knee joint of the intact leg and smaller than that of the control group.The total knee flexions in the laboratory measurements were comparable with field measurements.Additional load affects the RoM of the ski boot, ankle and knee joints for the amputated skier in both legs. No significant influence from the additional load was found on the RoM in the control group of healthy subjects.The above-knee prosthesis with a multiple-axis prosthetic knee reproduces the alpine skiing kinematics of an intact leg.
本研究的目的是分析大腿假肢的滑雪靴、踝关节和膝关节的屈曲角度，并将其与健全肢体以及一组对照滑雪者进行比较。一名右大腿截肢者和八名健康受试者在实验室条件下通过双腿深蹲模拟滑雪转弯动作。通过按体重比例（BW；+1/3 BW、+2/3 BW、+3/3 BW）增加额外负荷，模拟了各种滑雪状态。计算并比较了滑雪靴、踝关节和膝关节的屈曲角度变化（CoFA）和运动范围（RoM）。假肢侧滑雪靴的平均RoM（4.4±1.1°）明显低于健全肢体（5.9±1.8°）和对照组（6.5±2.3°）。在踝关节，假肢的平均RoM为13.2±2.9°，健全肢体为12.7±2.8°，对照组为14.8±3.6°。然而，假肢膝关节的RoM（42.2±4.2°）明显大于健全肢体膝关节的RoM（34.7±4.4°）。对照组膝关节的平均RoM为47.8±5.4°。额外负荷对下肢运动学的影响在假肢侧和健全肢体侧有所不同。相比之下，额外负荷在对照组中未产生任何显著差异。尽管滑雪靴、踝关节和膝关节使用了不同的CoFA，但带有内置多轴假肢膝关节的大腿假肢在模拟高山滑雪中能够实现可比的腿部运动学。关键点：假肢侧滑雪靴的RoM小于健全肢体和健康受试者对照组的RoM。假肢侧踝关节的RoM与健全肢体和健康受试者对照组的RoM相当。假肢膝关节的RoM大于健全肢体膝关节的RoM且小于对照组的RoM。实验室测量中的总膝关节屈曲与现场测量结果相当。额外负荷影响双腿截肢滑雪者滑雪靴、踝关节和膝关节的RoM。在健康受试者对照组中未发现额外负荷对RoM有显著影响。带有多轴假肢膝关节的大腿假肢可再现健全肢体的高山滑雪运动学。
