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使用混合辅助肢体训练对全膝关节置换术后步态周期运动学的影响。

Effect of Training With the Hybrid Assistive Limb on Gait Cycle Kinematics After Total Knee Arthroplasty.

作者信息

Fukaya Takashi, Mutsuzaki Hirotaka, Yoshikawa Kenichi, Koseki Kazunori, Iwai Koichi

机构信息

Department of Physical Therapy, Faculty of Health Sciences, Tsukuba International University, Tsuchiura, Ibaraki, Japan.

Centre for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan.

出版信息

Geriatr Orthop Surg Rehabil. 2021 Oct 8;12:21514593211049075. doi: 10.1177/21514593211049075. eCollection 2021.

Abstract

INTRODUCTION

Reportedly, wearable robots, such as the hybrid assistive limb (HAL), are effective in the functional recovery of various locomotor disabilities, including disrupted walking, restricted range of motion, and muscle weakness. However, the effect of walking exercises with a HAL on the kinematic and kinetic variables of lower limb joint function is not yet fully understood. Therefore, the purpose of this study was to elucidate the effect of HAL on the kinematic and kinetic variables of lower limb function in patients 5 weeks after total knee arthroplasty (TKA).

MATERIALS AND METHODS

Nine patients (ten knees) in the HAL training group and nine patients (nine knees) in the control group underwent TKA. HAL training was initiated 1-5 weeks after TKA, and general rehabilitation was performed in the control group. Gait analysis was performed on each patient using a motion analysis system at 5 weeks after TKA. We compared the effects of the joint angles of the walking cycle between groups, and investigated the effect of the walking cycle's joint angles on step length.

RESULTS

In the HAL group, the odds ratio of hip extension was as large as 1.741, while that of knee swing was as large as 1.501. These 2 variables were significant between the 2 groups. Knee swing and varus significantly affected step length.

CONCLUSIONS

Our results suggest that training by wearing HAL after TKA increased the mobility of the knee and hip joints during early postoperative walking, and that walking ability was improved by increasing the step length.

摘要

引言

据报道,可穿戴机器人,如混合辅助肢体(HAL),在各种运动功能障碍的功能恢复中有效,包括行走中断、活动范围受限和肌肉无力。然而,使用HAL进行步行训练对下肢关节功能的运动学和动力学变量的影响尚未完全了解。因此,本研究的目的是阐明HAL对全膝关节置换术(TKA)后5周患者下肢功能的运动学和动力学变量的影响。

材料与方法

HAL训练组的9名患者(10个膝关节)和对照组的9名患者(9个膝关节)接受了TKA。HAL训练在TKA后1-5周开始,对照组进行常规康复训练。在TKA后5周使用运动分析系统对每位患者进行步态分析。我们比较了两组之间步行周期的关节角度的影响,并研究了步行周期的关节角度对步长的影响。

结果

在HAL组中,髋关节伸展的优势比高达1.741,而膝关节摆动的优势比高达1.501。这两个变量在两组之间具有显著性差异。膝关节摆动和内翻显著影响步长。

结论

我们的结果表明,TKA后佩戴HAL进行训练可增加术后早期步行时膝关节和髋关节的活动度,并且通过增加步长改善了步行能力。

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