Adamczyk Peter Gabriel, Roland Michelle, Hahn Michael E
Intelligent Prosthetic Systems, LLC, Madison, WI, USA; The University of Michigan, Ann Arbor, MI, USA.
The University of Oregon, Eugene, OR, USA; Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, U.S. Dept. of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
Hum Mov Sci. 2017 Aug;54:154-171. doi: 10.1016/j.humov.2017.04.005. Epub 2017 May 9.
Many studies have reported the effects of different foot prostheses on gait, but most results cannot be generalized because the prostheses' properties are seldom reported. We varied hindfoot and forefoot stiffness in an experimental foot prosthesis, in increments of 15N/mm, and tested the parametric effects of these variations on treadmill walking in unilateral transtibial amputees, at speeds from 0.7 to 1.5m/s. We computed outcomes such as prosthesis energy return, center of mass (COM) mechanics, ground reaction forces, and joint mechanics, and computed their sensitivity to component stiffness. A stiffer hindfoot led to reduced prosthesis energy return, increased ground reaction force (GRF) loading rate, and greater stance-phase knee flexion and knee extensor moment. A stiffer forefoot resulted in reduced prosthetic-side ankle push-off and COM push-off work, and increased knee extension and knee flexor moment in late stance. The sensitivity parameters obtained from these tests may be useful in clinical prescription and further research into compensatory mechanisms of joint function.
许多研究报告了不同足部假肢对步态的影响，但大多数结果无法推广，因为很少有研究报告假肢的特性。我们在一个实验性足部假肢中改变后足和前足的刚度，以15N/mm的增量进行变化，并测试这些变化对单侧经胫骨截肢者在跑步机上行走的参数效应，行走速度为0.7至1.5m/s。我们计算了诸如假肢能量回返、质心（COM）力学、地面反作用力和关节力学等结果，并计算了它们对部件刚度的敏感性。更硬的后足导致假肢能量回返减少、地面反作用力（GRF）加载率增加，以及站立期膝关节屈曲和膝关节伸肌力矩增大。更硬的前足导致假肢侧踝关节蹬离和COM蹬离功减少，以及站立后期膝关节伸展和膝关节屈肌力矩增加。从这些测试中获得的敏感性参数可能有助于临床处方以及对关节功能代偿机制的进一步研究。
