Gaffney Brecca M, Murray Amanda M, Christiansen Cory L, Davidson Bradley S
Department of Mechanical and Materials Engineering, University of Denver, Denver, CO, United States.
Physical Therapy Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Gait Posture. 2016 Mar;45:151-6. doi: 10.1016/j.gaitpost.2016.01.015. Epub 2016 Jan 25.
Patients with unilateral dysvascular transtibial amputation (TTA) have a higher risk of developing low back pain than their healthy counterparts, which may be related to movement compensations used in the absence of ankle function. Assessing components of segmental angular momentum provides a unique framework to identify and interpret these movement compensations alongside traditional observational analyses. Angular momentum separation indicates two components of total angular momentum: (1) transfer momentum and (2) rotational momentum. The objective of this investigation was to assess movement compensations in patients with dysvascular TTA, patients with diabetes mellitus (DM), and healthy controls (HC) by examining patterns of generating and arresting trunk and pelvis segmental angular momenta during gait. We hypothesized that all groups would demonstrate similar patterns of generating/arresting total momentum and transfer momentum in the trunk and pelvis in reference to the groups (patients with DM and HC). We also hypothesized that patients with amputation would demonstrate different (larger) patterns of generating/arresting rotational angular momentum in the trunk. Patients with amputation demonstrated differences in trunk and pelvis transfer angular momentum in the sagittal and transverse planes in comparison to the reference groups, which indicates postural compensations adopted during walking. However, patients with amputation demonstrated larger patterns of generating and arresting of trunk and pelvis rotational angular momentum in comparison to the reference groups. These segmental rotational angular momentum patterns correspond with high eccentric muscle demands needed to arrest the angular momentum, and may lead to consequential long-term effects such as low back pain.
单侧血管性经胫骨截肢（TTA）患者比健康人患腰痛的风险更高，这可能与在缺乏踝关节功能时所采用的运动代偿有关。评估节段角动量的组成部分提供了一个独特的框架，可与传统的观察性分析一起识别和解释这些运动代偿。角动量分离表明总角动量的两个组成部分：（1）转移动量和（2）旋转动量。本研究的目的是通过检查步态期间躯干和骨盆节段角动量的产生和终止模式，评估血管性TTA患者、糖尿病（DM）患者和健康对照（HC）的运动代偿情况。我们假设，与DM患者和HC组相比，所有组在躯干和骨盆中产生/终止总动量和转移动量的模式相似。我们还假设，截肢患者在躯干中产生/终止旋转角动量的模式会有所不同（更大）。与参照组相比，截肢患者在矢状面和横断面的躯干和骨盆转移角动量存在差异，这表明行走过程中采用了姿势代偿。然而，与参照组相比，截肢患者在躯干和骨盆旋转角动量的产生和终止方面表现出更大的模式。这些节段旋转角动量模式与终止角动量所需的高离心肌肉需求相对应，可能会导致诸如腰痛等长期后果。
