The Royal British Legion Centre for Blast Injury Studies, Imperial College London, UK; The Department of Bioengineering, Imperial College London, UK.
The Royal British Legion Centre for Blast Injury Studies, Imperial College London, UK; The Department of Bioengineering, Imperial College London, UK.
J Biomech. 2021 Aug 26;125:110599. doi: 10.1016/j.jbiomech.2021.110599. Epub 2021 Jun 29.
Amputation of a major limb, and the subsequent return to movement with a prosthesis, requires the development of compensatory strategies to account for the loss. Such strategies, over time, lead to regional muscle atrophy and hypertrophy through chronic under or overuse of muscles compared to uninjured individuals. The aim of this study was to quantify the lower limb muscle parameters of persons with transtibial and transfemoral amputations using high resolution MRI to ascertain muscle volume and to determine regression equations for predicting muscle volume using femur- and tibia-length, pelvic-width, height, and mass. Twelve persons with limb loss participated in this study and their data were compared to six matched control subjects. Subjects with unilateral transtibial amputation showed whole-limb muscle volume loss in the residual-limb, whereas minor volume changes in the intact limb were found, providing evidence for a compensation strategy that is dominated by the intact-limb. Subjects with bilateral-transfemoral amputations showed significant muscle volume increases in the short adductor muscles with an insertion not affected by the amputation, the hip flexors, and the gluteus medius, and significant volume decreases in the longer adductor muscles, rectus femoris, and hamstrings. This study presents a benchmark measure of muscle volume discrepancies in persons with limb-loss, and can be used to understand the compensation strategies of persons with limb-loss and the impact on muscle volume, thus enabling the development of optimised intervention protocols, conditioning therapies, surgical techniques, and prosthetic devices that promote and enhance functional capability within the population of persons with limb loss.
主要肢体的截肢，以及随后使用假肢重新恢复运动，需要开发补偿策略来弥补损失。随着时间的推移，与未受伤的个体相比，这些策略会导致肌肉慢性过度或不足使用，从而导致区域性肌肉萎缩和肥大。本研究的目的是使用高分辨率 MRI 量化小腿和大腿截肢者的下肢肌肉参数，以确定肌肉体积，并确定使用股骨和胫骨长度、骨盆宽度、身高和体重预测肌肉体积的回归方程。12 名肢体缺失者参加了这项研究，他们的数据与 6 名匹配的对照组进行了比较。单侧小腿截肢者的整个肢体肌肉体积在残肢中丢失，而未受伤肢体的体积变化较小，这提供了一个以未受伤肢体为主导的补偿策略的证据。双侧大腿截肢者的短内收肌、不受截肢影响的内收肌附着点、髋关节屈肌和臀中肌的肌肉体积显著增加，而较长的内收肌、股直肌和腘绳肌的肌肉体积显著减少。本研究提供了肢体缺失者肌肉体积差异的基准测量方法，可用于了解肢体缺失者的补偿策略及其对肌肉体积的影响，从而能够制定优化的干预方案、康复治疗、手术技术和假肢，以促进和增强肢体缺失者人群的功能能力。
