Darter Benjamin J, Bastian Amy J, Wolf Erik J, Husson Elizabeth M, Labrecque Bethany A, Hendershot Brad D
Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia, United States of America.
Department of Research, Hunter Holmes McGuire Veteran Affairs Medical Center, Richmond, Virginia, United States of America.
PLoS One. 2017 Jul 12;12(7):e0181120. doi: 10.1371/journal.pone.0181120. eCollection 2017.
Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood.
Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA).
The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds. In the split condition, participants walked for 15 minutes with the respective belts moving at 0.5 m/s and 1.5 m/s. Temporal spatial symmetry measures were used to evaluate reactive accommodations to the perturbation, and the adaptive/de-adaptive response.
Persons with TTA and the reference group of persons without amputation both demonstrated highly symmetric walking at baseline. During the split adaptation and tied post-adaptation walking both groups responded with the expected reactive accommodations. Likewise, adaptive and de-adaptive responses were observed. The magnitude and rate of change in the adaptive and de-adaptive responses were similar for persons with TTA and those without an amputation. Furthermore, adaptability was no different based on belt assignment for the prosthetic limb during split adaptation walking.
Reactive changes and locomotor adaptation in response to a challenging and novel walking condition were similar in persons with TTA to those without an amputation. Results suggest persons with TTA have the capacity to modify locomotor strategies to meet the demands of most walking conditions despite challenges imposed by an amputation and use of a prosthetic limb.
运动适应性使步行者在面对具有挑战性的步行条件时能够调整策略。虽然多种神经损伤会损害运动适应性，但下肢截肢对适应性的影响却知之甚少。
确定单侧经胫骨截肢（TTA）患者的运动适应性是否受损。
对10名TTA患者和8名未截肢者在分体式跑步机上行走时的运动适应性进行测试，跑步机的平行皮带以相同（系紧）或不同（分开）速度运行。在分开条件下，参与者在各自皮带分别以0.5米/秒和1.5米/秒的速度移动的情况下行走15分钟。使用时空对称性测量来评估对扰动的反应性调节以及适应性/去适应性反应。
TTA患者和未截肢的参照组在基线时均表现出高度对称的行走。在分开适应和系紧的适应后行走过程中，两组均做出了预期的反应性调节。同样，观察到了适应性和去适应性反应。TTA患者和未截肢者的适应性和去适应性反应的变化幅度和速率相似。此外，在分开适应行走期间，基于假肢肢体的皮带分配，适应性没有差异。
TTA患者对具有挑战性的新步行条件的反应性变化和运动适应性与未截肢者相似。结果表明，尽管截肢和使用假肢带来了挑战，但TTA患者有能力调整运动策略以满足大多数步行条件的需求。
