Hullfish Todd J, O'Connor Kathryn M, Baxter Josh R
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
J Biomech. 2020 Aug 26;109:109925. doi: 10.1016/j.jbiomech.2020.109925. Epub 2020 Jul 1.
Achilles tendon ruptures are common injuries that lead to functional deficits in two-thirds of patients. Progressively loading the healing tendon has been associated with superior outcomes, but the loading profiles that patients experience throughout rehabilitation have not yet been established. In this study, we developed and calibrated an instrumented immobilizing boot paradigm that is aimed at longitudinally quantifying patient loading biomechanics to develop personalized rehabilitation protocols. We used a 3-part instrumented insole to quantify the ankle loads generated by the Achilles tendon and secured a load cell inline with the posterior strut of the immobilizing boot to quantify boot loading. We then collected gait data from five healthy young adults to demonstrate the validity of this instrumented immobilizing boot paradigm to assess Achilles tendon loading during ambulation. We developed a simple calibration procedure to improve the measurement fidelity of the instrumented insole needed to quantify Achilles tendon loading while ambulating with an immobilizing boot. By assessing Achilles tendon loading with the ankle constrained to 0 degrees and 30 degrees plantar flexion, we confirmed that walking with the foot supported in plantar flexion decreased Achilles tendon loading by 60% (P < 0.001). This instrumented immobilizing boot paradigm leverages commercially available sensors and logs data using a small microcontroller secured to the boot and a handheld device, making our paradigm capable of continuously monitoring biomechanical loading outside of the lab or clinic.
跟腱断裂是常见损伤，会导致三分之二的患者出现功能缺陷。逐渐增加愈合中跟腱的负荷与更好的治疗效果相关，但患者在整个康复过程中所经历的负荷情况尚未明确。在本研究中，我们开发并校准了一种带有传感器的固定靴模型，旨在纵向量化患者的负荷生物力学，以制定个性化的康复方案。我们使用一个由三部分组成的带传感器鞋垫来量化跟腱产生的踝关节负荷，并在固定靴的后支柱处串联一个测力传感器来量化靴子的负荷。然后，我们收集了五名健康年轻成年人的步态数据，以证明这种带有传感器的固定靴模型在评估行走过程中跟腱负荷方面的有效性。我们开发了一种简单的校准程序，以提高在穿着固定靴行走时量化跟腱负荷所需的带传感器鞋垫的测量保真度。通过在踝关节分别受限至0度和30度跖屈的情况下评估跟腱负荷，我们证实，足部在跖屈状态下行走时，跟腱负荷降低了60%（P < 0.001）。这种带有传感器的固定靴模型利用了市售传感器，并通过固定在靴子上的一个小型微控制器和一个手持设备记录数据，使我们的模型能够在实验室或诊所之外持续监测生物力学负荷。
