Loyd Brian J, Fields Thomas T, Stephenson Ryan O, Stevens-Lapsley Jennifer, Christiansen Cory L
Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO.
Department of Physical Medicine and Rehabilitation, Denver Veterans Administration (VA) Medical Center, Denver, CO.
J Rehabil Res Dev. 2016;53(6):1035-1044. doi: 10.1682/JRRD.2015.03.0038.
Little evidence exists to support the presence of differences in spatiotemporal gait parameters and ambulation ability between those individuals with traumatic and nontraumatic lower-limb amputation (LLA). We conducted an exploratory study of 81 male Veterans with unilateral amputation to quantify differences in spatiotemporal gait parameters and ambulatory mobility between Veterans with traumatic and nontraumatic LLA. Furthermore, we identified variables that significantly contributed to the explanation of variability in modified 2-min walk test distance. All participants completed the modified 2-min walk test and a spatiotemporal gait analysis using an instrumented walkway during a routine physical therapy visit. Veterans with nontraumatic LLA walked significantly shorter mean distances during a modified 2-min walk test than Veterans with traumatic LLA. Variables identified as significant contributors to modified 2-min walk test variability were amputated limb stance time, amputated limb step length, and percentage of the gait cycle spent in double support. These findings demonstrate that differences in spatiotemporal gait parameters and ambulatory mobility exist between Veterans with traumatic and nontraumatic LLA and identify important spatiotemporal parameters of gait contributing to this decline. These parameters should be considered as targets for intervention and future investigation.
几乎没有证据支持创伤性和非创伤性下肢截肢(LLA)患者在时空步态参数和步行能力方面存在差异。我们对81名单侧截肢的男性退伍军人进行了一项探索性研究,以量化创伤性和非创伤性LLA退伍军人在时空步态参数和步行移动性方面的差异。此外,我们确定了对解释改良2分钟步行测试距离变异性有显著贡献的变量。所有参与者在常规物理治疗就诊期间完成了改良2分钟步行测试,并使用仪器化走道进行了时空步态分析。非创伤性LLA退伍军人在改良2分钟步行测试中的平均步行距离明显短于创伤性LLA退伍军人。被确定为改良2分钟步行测试变异性显著贡献因素的变量是截肢肢体站立时间、截肢肢体步长以及双支撑期占步态周期的百分比。这些发现表明,创伤性和非创伤性LLA退伍军人在时空步态参数和步行移动性方面存在差异,并确定了导致这种下降的重要步态时空参数。这些参数应被视为干预和未来研究的目标。