Gardiner James, Bari Abu Zeeshan, Howard David, Kenney Laurence
School of Computing, Science and Engineering and.
School of Health Sciences, University of Salford, Salford, UK.
J Rehabil Res Dev. 2016;53(6):1133-1138. doi: 10.1682/JRRD.2015.04.0066.
Energy storage and return (ESR) feet have long been assumed to promote metabolically efficient amputee gait. However, despite being prescribed for approximately 30 yr, there is limited evidence that they achieve this desired function. Here, we report a meta-analysis of data from 10 studies that met our selection criteria to determine whether amputee walking with ESR feet is more efficient than with conventional solid ankle cushioned heel (SACH) feet. Additionally, the data were tested for a relationship with walking speed since it has been suggested ESR feet might perform better at higher speeds. The raw data are highly variable because of differences in study protocols; therefore, we normalized the data and found a statistically significant difference (p < 0.001) between ESR and SACH feet. However, the magnitude of this difference is small, with the cost of transport (COT) with ESR feet being 97.3% of the cost with SACH feet. No relationship between ESR COT and speed was found (p = 0.19). We hypothesize that the small but statistically significant difference between ESR and SACH feet may not constitute a functionally significant improvement in COT, possibly related to the limited push-off power provided by ESR feed compared with nondisabled ankles.
长期以来，人们一直认为能量储存与回馈（ESR）假脚能够提升截肢者步态的代谢效率。然而，尽管ESR假脚已被应用约30年，但仅有有限的证据表明它们能实现这一预期功能。在此，我们对10项符合我们选择标准的研究数据进行了荟萃分析，以确定使用ESR假脚行走的截肢者是否比使用传统实心踝软跟（SACH）假脚更高效。此外，由于有人提出ESR假脚在较高速度下可能表现更佳，因此我们对数据进行了与步行速度关系的测试。由于研究方案的差异，原始数据具有高度变异性；因此，我们对数据进行了标准化处理，发现ESR假脚和SACH假脚之间存在统计学上的显著差异（p < 0.001）。然而，这种差异的幅度较小，使用ESR假脚时的运输成本（COT）是使用SACH假脚时成本的97.3%。未发现ESR假脚的COT与速度之间存在关联（p = 0.19）。我们推测，ESR假脚和SACH假脚之间虽存在微小但具有统计学意义的差异，但可能并不构成COT在功能上的显著改善，这可能与ESR假脚相比健全脚踝提供的蹬地力量有限有关。
