Fontes Filho Carlos Henrique da Silva, Laett Conrado Torres, Gavilão Ubiratã Faleiro, Campos José Carlos de, Alexandre Dângelo José de Andrade, Cossich Victor R A, Sousa Eduardo Branco de
Centro de Amputados, Unidade de Reabilitacao, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, BR.
Laboratorio de Pesquisa Neuromuscular, Divisao de Pesquisa, Instituto Nacional de Traumatologia e Ortopedia (INTO), Rio de Janeiro, RJ, BR.
Clinics (Sao Paulo). 2021 Apr 26;76:e2486. doi: 10.6061/clinics/2021/e2486. eCollection 2021.
To evaluate how transtibial amputation (TT) affects bodyweight distribution, voluntary knee joint position sense (JPS), and quadriceps (QUA) and hamstrings (HAM) strength in prosthetized patients.
Only TT patients who had been prosthetized for more than one year were included, and an age-paired able-bodied group was used as control. The participants stood on force plates with their eyes open to measure bodyweight distribution between the limbs. Knee voluntary JPS was assessed by actively reproducing a set of given arbitrary joint angles using a video analysis approach, and QUA and HAM strength were assessed isometrically with a hand-held dynamometer.
Sixteen TT subjects (age: 39.4±4.8 years) and sixteen age-paired control subjects (age: 38.4±4.3 years) participated in the study. The amputees supported their bodyweight majorly on the sound limb (54.8±8.3%, p<0.001). The proprioceptive performance was similar between the amputated (absolute error (AE): 2.2±1.6°, variable error (VE): 1.9±1.6°, constant error (CE): -0.7±2.0°) and non-amputated limbs (AE: 2.6±0.9°, VE: 2.1±0.9°, CE: 0.02±2.3°), and was not different from that of control subjects (AE: 2.0±0.9°, VE: 1.4±0.4°, CE: -1.1±1.7°). There was a considerable weakness of the QUA and HAM in the amputated limb compared with the sound limb and control subjects (p<0.001 both).
The asymmetric bodyweight distribution in the transtibial amputees was not accompanied by a reduction in knee proprioception. There was significant weakness in the amputated limb, which could be a potential issue when designing rehabilitation programs.
评估经胫骨截肢（TT）对接受假肢治疗患者的体重分布、膝关节主动位置觉（JPS）以及股四头肌（QUA）和腘绳肌（HAM）力量的影响。
仅纳入已接受假肢治疗超过一年的TT患者，并以年龄匹配的健全人群作为对照组。参与者睁眼站立在测力板上，以测量两下肢之间的体重分布。采用视频分析方法，通过主动重现一组给定的任意关节角度来评估膝关节主动JPS，并用手持测力计等长评估QUA和HAM力量。
16名TT受试者（年龄：39.4±4.8岁）和16名年龄匹配的对照受试者（年龄：38.4±4.3岁）参与了本研究。截肢者主要依靠健侧肢体支撑体重（54.8±8.3%，p<0.001）。截肢侧肢体（绝对误差（AE）：2.2±1.6°，可变误差（VE）：1.9±1.6°，恒定误差（CE）：-0.7±2.0°）与非截肢侧肢体（AE：2.6±0.9°，VE： 2. 1±0.9°，CE：0.02±2.3°）的本体感觉表现相似，且与对照受试者（AE：2.0±0.9°，VE：1.4±0.4°，CE：-1.1±1.7°）无差异。与健侧肢体和对照受试者相比，截肢侧肢体的QUA和HAM明显无力（两者p<0.001）。
经胫骨截肢者体重分布不对称，但并未伴有膝关节本体感觉减退。截肢侧肢体存在明显无力，这在设计康复方案时可能是一个潜在问题。
