From the School of Physical Therapy, Regis University, Denver, Colorado (BSB); Department of Kinesiology, University of Maryland, College Park (BSB, KK, HJK, RHM, JKS); National Institute of Advanced Industrial Science and Technology, Tokyo, Japan (HH); Neuroscience and Cognitive Science Program and Fischell Department of Bioengineering, University of Maryland, College Park (JKS); and Department of Mechanical Engineering, Kyung Hee University, Yong-In, Korea (JKS).
Am J Phys Med Rehabil. 2019 Mar;98(3):182-190. doi: 10.1097/PHM.0000000000000905.
The objective of this study was to investigate three-dimensional lower extremity joint moment differences between limbs and speed influences on these differences in individuals with lower extremity amputations using running-specific prostheses.
Eight individuals with unilateral transtibial amputations and 8 control subjects with no amputations ran overground at three constant velocities (2.5, 3.0, and 3.5 m/sec). A 2 × 2 × 3 (group × leg × speed) repeated-measures analysis of variance with Bonferroni adjustments determined statistical significance.
The prosthetic limb generated significantly greater peak ankle plantarflexion moments and smaller peak ankle varus, knee stance extension, knee swing flexion, knee internal rotation, hip stance flexion, hip swing flexion, hip swing extension, hip valgus, and hip external rotation moments than the intact limb did. The intact limb had greater peak hip external rotation moments than control limbs did, but all other peak moments were similar between these limbs. Increases in peak hip stance and knee swing flexion moments associated with speed were greater in the intact limb than in the prosthetic limb.
Individuals with amputation relied on the intact limb more than the prosthetic limb to run at a particular speed when wearing running-specific prostheses, but the intact joints were not overloaded relative to the control limbs.
本研究旨在探讨使用特定于跑步的假肢的下肢截肢者四肢之间三维下肢关节力矩差异以及速度对这些差异的影响。
8 名单侧胫骨截肢者和 8 名无截肢者在三个恒定速度（2.5、3.0 和 3.5 m/sec）下在地面上跑步。采用 2×2×3（组×腿×速度）重复测量方差分析和 Bonferroni 调整确定统计学意义。
假肢产生的峰值踝关节跖屈力矩明显大于完整肢体，而峰值踝关节内翻、膝关节站立伸展、膝关节摆动屈曲、膝关节内旋、髋关节站立屈曲、髋关节摆动屈曲、髋关节摆动伸展、髋关节外翻和髋关节外旋力矩则小于完整肢体。完整肢体的峰值髋关节外旋力矩大于对照组肢体，但这些肢体的所有其他峰值力矩相似。与速度相关的峰值髋关节站立和膝关节摆动屈曲力矩的增加在完整肢体中大于假肢。
当使用特定于跑步的假肢时，截肢者比假肢更依赖于完整肢体以达到特定的速度，但与对照组相比，完整关节并未过载。
