Kahle Jason T, Klenow Tyler D, Sampson William J, Highsmith M Jason
OP Solutions, Tampa, FL, USA; Prosthetic Design + Research, Tampa, FL, USA.
Prosthetics and Sensory Aids Service, James A. Haley Veterans' Hospital, Tampa, FL, USA.
Technol Innov. 2016 Sep;18(2-3):167-173. doi: 10.21300/18.2-3.2016.167.
Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables). Dependent variables included the Activity-specific Balance Scale (ABC) and the two-minute walk test (2MWT). Complete records were available for 13 patients ( = 13). The age range was 26 to 58 years. Three patients functioned at the K4 activity level, whereas all others functioned at the K3 level. Mean ABC scores were significantly different ( ≤ 0.05) at 77.2 (±16.8; 35.6 to 96.9) for IRC and 90.7 (±5.7; 77.5 to 98.7) for HiFi. The mean distance walked on the 2MWT was 91.8 m (±22.0, 58.3 to 124.7) for IRC compared to 110.4 m (±28.7; 64.7 to 171.1) for the HiFi socket ( ≤ 0.05). Alternative transfemoral interface design, such as the HiFi socket, can improve walking capacity and balance confidence in higher-functioning TFA patients.
跌倒和步行能力下降是经股截肢（TFA）患者常见的损伤。在制定假肢处方时，应考虑通过实现更正常的步态速度和社区行走等方式来减少跌倒并优化步行能力。由于TFA会损害步行能力和平衡信心，因此在评估经股假肢使用者的接口时应考虑这些结果。本研究的目的是比较TFA接口设计对步行能力和平衡信心的影响。采用回顾性队列设计，纳入使用坐骨支包容（IRC）和高保真（HiFi）接口（自变量）的单侧TFA患者。因变量包括特定活动平衡量表（ABC）和两分钟步行测试（2MWT）。共有13例患者（n = 13）有完整记录。年龄范围为26至58岁。3例患者功能处于K4活动水平，而其他所有患者功能处于K3水平。IRC组的平均ABC评分为77.2（±16.8；35.6至96.9），HiFi组为90.7（±5.7；77.5至98.7），差异有统计学意义（P≤0.05）。IRC组在2MWT上的平均步行距离为91.8米（±22.0，58.3至124.7），而HiFi接受腔组为110.4米（±28.7；64.7至171.1），差异有统计学意义（P≤0.05）。替代性经股接口设计，如HiFi接受腔，可提高功能较高的TFA患者的步行能力和平衡信心。
