Jarvis Hannah L, Bennett Alex N, Twiste Martin, Phillip Rhodri D, Etherington John, Baker Richard
Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, UK; School of Health Sciences, University of Salford, Salford, UK.
Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Surrey, UK; United National Institute for Prosthetics and Orthotics Development, University of Salford, Salford, UK; Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, UK.
Arch Phys Med Rehabil. 2017 Jul;98(7):1389-1399. doi: 10.1016/j.apmr.2016.09.134. Epub 2016 Nov 16.
To record the temporal spatial parameters and metabolic energy expenditure during walking of individuals with amputation, walking with advanced prostheses, and after completion of comprehensive rehabilitation compared with able-bodied persons.
Cross-sectional.
Multidisciplinary comprehensive rehabilitation center.
Severely injured UK military personnel with amputation and subsequent completion of their rehabilitation program (n=30; unilateral transtibial: n=10, unilateral transfemoral: n=10, and bilateral transfemoral: n=10) were compared with able-bodied persons (n=10) with similar age, height, and mass (P>.537). Total number of participants (N = 40).
Not applicable.
Temporal spatial and metabolic energy expenditure data were captured during walking on level ground at a self-selected speed.
The individuals with amputation were all men, with a mean age of 29±4 years and a mean New Injury Severity Score of 31±16. Walking speed, stride length, step length, and cadence of individuals with a unilateral transtibial or transfemoral amputation were comparable with able-bodied persons, and only individuals with a bilateral transfemoral amputation had a significantly slower walking speed (1.12m/s, P=.025) and reduced cadence (96 steps per minute, P=.026). Oxygen cost for individuals with a unilateral transtibial amputation (0.15mL/kg/m) was the same as for able-bodied persons (0.15mL/kg/m) and significantly increased by 20% (0.18mL/kg/m, P=.023) for unilateral transfemoral amputation and by 60% (0.24mL/kg/m, P<.001) for bilateral transfemoral individuals with amputation.
The scientific literature reports a wide range of gait and metabolic energy expenditure across individuals with amputation. The results of this study indicate that individuals with amputation have a gait pattern which is highly functional and efficient. This is comparable with a small number of studies reporting similar outcomes for individuals with a unilateral transtibial amputation, but the results from this study are better than those on individuals with transfemoral amputations reported elsewhere, despite comparison with populations wearing similar prosthetic componentry. Those studies that do report similar outcomes have included individuals who have been provided with a comprehensive rehabilitation program. This suggests that such a program may be as important as, or even more important than, prosthetic component selection in improving metabolic energy expenditure. The data are made available as a benchmark for what is achievable in the rehabilitation of some individuals with amputations, but agreeably may not be possible for all amputees to achieve.
记录截肢者、使用先进假肢行走者以及完成综合康复后的截肢者在行走过程中的时空参数和代谢能量消耗，并与健全人进行比较。
横断面研究。
多学科综合康复中心。
将重度受伤的英国截肢军事人员及其随后完成康复计划者（n = 30；单侧胫部截肢：n = 10，单侧股部截肢：n = 10，双侧股部截肢：n = 10）与年龄、身高和体重相似的健全人（n = 10）进行比较（P>.537）。参与者总数（N = 40）。
不适用。
在平地上以自选速度行走时记录时空参数和代谢能量消耗数据。
截肢者均为男性，平均年龄29±4岁，平均新损伤严重程度评分为31±16。单侧胫部或股部截肢者的步行速度、步幅、步长和步频与健全人相当，只有双侧股部截肢者的步行速度明显较慢（1.12m/s，P = .025）且步频降低（每分钟96步，P = .026）。单侧胫部截肢者的氧耗（0.15mL/kg/m）与健全人相同（0.15mL/kg/m），单侧股部截肢者的氧耗显著增加20%（0.18mL/kg/m，P = .023），双侧股部截肢者的氧耗增加60%（0.24mL/kg/m，P<.001）。
科学文献报道了截肢者之间广泛的步态和代谢能量消耗情况。本研究结果表明，截肢者具有高度功能性和高效性的步态模式。这与少数关于单侧胫部截肢者的类似研究结果相当，但本研究结果优于其他地方报道的股部截肢者的结果，尽管与佩戴类似假肢组件的人群进行了比较。那些确实报告了类似结果的研究纳入了接受过综合康复计划的个体。这表明，在改善代谢能量消耗方面，这样的计划可能与假肢组件的选择同样重要，甚至更为重要。这些数据可作为一些截肢者康复可实现目标的基准，但并非所有截肢者都可能达到这一目标，这是令人欣慰的。
