小腿截肢者平地行走中的假肢蹬地力量：系统评价。
Prosthetic push-off power in trans-tibial amputee level ground walking: A systematic review.
机构信息
Department of Orthopedic Surgery, Klinikum Bayreuth GmbH, Bayreuth, Germany.
Institute of Sport Sciences, Friedrich Schiller University Jena, Jena, Germany.
出版信息
PLoS One. 2019 Nov 19;14(11):e0225032. doi: 10.1371/journal.pone.0225032. eCollection 2019.
OBJECTIVE
Unilateral trans-tibial amputation signifies a challenge to locomotion. Prosthetic ankle-foot units are developed to mimic the missing biological system which adapts push-off power to walking speed in some new prosthetic ankle-foot designs. The first systematic review including the two factors aims to investigate push-off power differences among Solid Ankle Cushion Heel (SACH), Energy Storage And Return (ESAR) and Powered ankle-foot units (PWR) and their relation to walking speed.
DATA SOURCES
A literature search was undertaken in the Web of Science, PubMed, IEEE xplore, and Google Scholar databases. The search term included: ampu* AND prosth* AND ankle-power AND push-off AND walking.
STUDY APPRAISAL AND SYNTHESIS METHODS
Studies were included if they met the following criteria: unilateral trans-tibial amputees, lower limb prosthesis, reported analysis of ankle power during walking. Data extracted from the included studies were clinical population, type of the prosthetic ankle-foot units (SACH, ESAR, PWR), walking speed, and peak ankle power. Linear regression was used to determine whether the push-off power of different prosthetic ankle-foot units varied regarding walking speed. Push-off power of the different prosthetic ankle-foot units were compared using one-way between subjects' ANOVAs with post hoc analysis, separately for slower and faster walking speeds.
RESULTS
474 publications were retrieved, 28 of which were eligible for inclusion. Correlations between walking speed and peak push-off power were found for ESAR (r = 0.568, p = 0.006) and PWR (r = 0.820, p = 0.000) but not for SACH (r = 0.267, p = 0.522). ESAR and PWR demonstrated significant differences in push-off power for slower and faster walking speeds (ESAR (p = 0.01) and PWR (p = 0.02)).
CONCLUSION
Push-off power can be used as a selection criterion to differentiate ankle-foot units for prosthetic users and their bandwidth of walking speeds.
目的
单侧小腿截肢对运动能力提出了挑战。假肢踝关节-足组件旨在模仿缺失的生物系统，在一些新型假肢踝关节-足组件设计中，根据步行速度自适应地调整蹬离力。本系统综述首次纳入这两个因素，旨在研究 Solid Ankle Cushion Heel（SACH）、Energy Storage And Return（ESAR）和 Powered ankle-foot units（PWR）三种踝关节-足组件的蹬离力差异及其与步行速度的关系。
资料来源
在 Web of Science、PubMed、IEEE xplore 和 Google Scholar 数据库中进行了文献检索。检索词包括：ampu和 prosth和 ankle-power 和 push-off 和 walking。
研究评估和综合方法
如果符合以下标准，研究将被纳入：单侧小腿截肢者、下肢假肢、报道了步行时踝关节功率的分析。从纳入的研究中提取的数据包括临床人群、假肢踝关节-足组件的类型（SACH、ESAR、PWR）、步行速度和峰值踝关节功率。线性回归用于确定不同假肢踝关节-足组件的蹬离力是否随步行速度而变化。使用单向受试者方差分析和事后分析分别比较不同假肢踝关节-足组件的蹬离力，对于较慢和较快的步行速度分别进行分析。
结果
共检索到 474 篇文献，其中 28 篇符合纳入标准。发现 ESAR（r = 0.568，p = 0.006）和 PWR（r = 0.820，p = 0.000）与步行速度呈正相关，但 SACH（r = 0.267，p = 0.522）与步行速度无相关性。ESAR 和 PWR 对于较慢和较快的步行速度，蹬离力存在显著差异（ESAR（p = 0.01）和 PWR（p = 0.02））。
结论
蹬离力可用作选择标准，区分假肢使用者的踝关节-足组件，并区分其步行速度范围。
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