Vertriest Sofie, Coorevits Pascal, Hagberg Kerstin, Brånemark Rickard, Häggström Eva Elisabet, Vanderstraeten Guy, Frossard Laurent Alain
1 Department of Physical and Rehabilitation Medicine, University Hospital, Ghent, Belgium.
2 Department of Public Health, Unit of Medical Informatics and Statistics, Ghent University, Ghent, Belgium.
Prosthet Orthot Int. 2017 Aug;41(4):393-401. doi: 10.1177/0309364616640949. Epub 2016 Apr 26.
Load-bearing exercises are performed by transfemoral amputees fitted with an osseointegrated implant to facilitate bone remodelling.
This study presents the loading compliance comparing loads prescribed and applied on the three axes of the implant during static load-bearing exercises with a specific emphasis on axial and vectorial comparisons.
Cohort study.
A total of 11 fully rehabilitated unilateral transfemoral amputees fitted with an osseointegrated implant performed five trials in four loading conditions using a static standing frame. The load prescribed was monitored using a vertical single-axis strain gauge connected to an electronic display. The tri-axial forces applied on the implant were measured directly with an instrumented pylon including a six-channel transducer. The analysis included 'axial' and 'vectorial' comparisons corresponding to the difference between the force applied on the long axis of the implant and the load prescribed as well as the resultant of the three components of the load applied and the load prescribed, respectively.
The results demonstrated that axial and vectorial differences were significant in all conditions ( p < 0.05), except for the vectorial difference for the 40 kg condition ( p = 0.182).
The significant lack of axial compliance led to systematic underloading of the long axis of the implant. Clinical relevance This study contributes to a better understanding of the load applied on an osseointegrated implant during the static load-bearing exercises that could contribute to improve the design of apparatus to monitor loading exercises as well as clinical guidelines for the loading progression during rehabilitation.
装有骨整合植入物的经股骨截肢者进行负重训练以促进骨重塑。
本研究比较了静态负重训练期间植入物三个轴向上规定负荷与实际施加负荷的负荷依从性，特别强调轴向和矢量比较。
队列研究。
11名装有骨整合植入物且已完全康复的单侧经股骨截肢者使用静态站立架在四种负荷条件下进行了五次试验。使用连接到电子显示器的垂直单轴应变仪监测规定负荷。使用包括六通道传感器的仪器塔直接测量施加在植入物上的三轴力。分析包括“轴向”和“矢量”比较，分别对应于施加在植入物长轴上的力与规定负荷之间的差异以及施加负荷和规定负荷的三个分量的合力。
结果表明，除40 kg负荷条件下的矢量差异外（p = 0.182），所有条件下轴向和矢量差异均具有统计学意义（p < 0.05）。
轴向依从性明显不足导致植入物长轴系统性负荷不足。临床意义本研究有助于更好地理解静态负重训练期间施加在骨整合植入物上的负荷，这可能有助于改进监测负荷训练的器械设计以及康复期间负荷进展的临床指南。
