Engdahl Susannah M, Lee Christina, Gates Deanna H
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; School of Kinesiology, University of Michigan, Ann Arbor, MI, USA.
Clin Biomech (Bristol). 2022 Jul;97:105713. doi: 10.1016/j.clinbiomech.2022.105713. Epub 2022 Jun 28.
People with upper limb absence use compensatory movements to accommodate lack of motion in the prosthetic hand. The purpose of this study was to determine if the type of prosthesis used (i.e. body-powered or myoelectric) affects compensatory movements during activities of daily living.
Twelve transradial body-powered and/or myoelectric prosthesis users performed up to six unimanual and bimanual activities of daily living. Trunk range of motion and peak upper limb angles for each task were compared between prostheses.
Compensatory movement generally did not differ based on prosthesis type. However, body-powered users had increased trunk lateral lean compared to myoelectric users during a deodorant application task (P = 0.025). Body-powered users also had increased trunk axial rotation (P = 0.048) and decreased shoulder elevation (P = 0.046) when transferring a box between shelves. Compensatory movements were not systematically correlated with duration of prosthesis ownership, socket comfort, or terminal device type.
A prosthesis user's compensatory movements may depend on other factors beyond whether the prosthesis terminal device is actuated through body-powered or myoelectric mechanisms. Further exploration of the factors that influence joint kinematics in prosthesis users may inform future prosthesis prescription practices and help patients become successful users.
上肢缺失者会运用代偿性动作来适应假手的运动缺失。本研究的目的是确定所使用的假体类型（即体动驱动型或肌电型）是否会影响日常生活活动中的代偿性动作。
12名经桡骨截肢的体动驱动型和/或肌电型假体使用者进行了多达六项单手和双手的日常生活活动。比较了不同假体在每项任务中的躯干运动范围和上肢峰值角度。
代偿性动作通常不因假体类型而异。然而，在涂抹除臭剂任务中，与肌电型使用者相比，体动驱动型使用者的躯干向患侧倾斜增加（P = 0.025）。在将盒子在架子之间转移时，体动驱动型使用者的躯干轴向旋转也增加（P = 0.048），而肩部抬高降低（P = 0.046）。代偿性动作与假体使用时长、接受腔舒适度或终端装置类型无系统性关联。
假体使用者的代偿性动作可能取决于假体终端装置是通过体动驱动还是肌电机制驱动之外的其他因素。对影响假体使用者关节运动学的因素进行进一步探索，可能会为未来的假体处方实践提供参考，并帮助患者成为成功的使用者。
