Veterans Health Service Medical Center, Department of Physical Medicine and Rehabilitation, Seoul 05368, Korea.
Veterans Health Service Medical Center, Center of Prosthetics and Orthotics, Seoul 05368, Korea.
Int J Environ Res Public Health. 2022 Jul 6;19(14):8279. doi: 10.3390/ijerph19148279.
Bilateral amputees are disadvantaged as they lack healthy leg support. We present the rare case of a bilateral transtibial amputee (BTA), in which we compared the first South Korean-made microprocessor-controlled prosthesis (MPA) to a conventional prosthetic ankle (CPA) with gait analysis and a patient questionnaire for long-term outcomes. A 70-year-old man presented with bilateral transtibial amputations from injury. Assessments were performed after wearing an MPA for 1 month and 1 year with three-dimensional gait analysis. Satisfaction, mobility, and pain were evaluated using the Korean version of the Prostheses Evaluation Questionnaire (K-PEQ). The spatiotemporal parameters of both sides showed increased stability from the CPA to 1 month (mMPA) and 1 year (yMPA). We observed an increased single support time, decreased step width, and almost normal stance-swing time ratio. In kinematic parameters, the ankle range of motion (ROM) was bilaterally increased at mMPA and yMPA. Unfortunately, the MPA gait showed insufficient ankle plantarflexion during the terminal stance that failed to generate push-up power. As the MPA adaptation time increased, the symmetry ratio improved to a balanced value. The questionnaire-based investigations of satisfaction, mobility, and pain revealed excellent results. The MPA proved helpful for ankle mobility in the BTA, and the questionnaire showed good satisfaction and mobility in varied terrain.
双侧截肢者处于不利地位,因为他们缺乏健康的腿部支撑。我们报告了一例罕见的双侧胫骨截肢(BTA)病例,我们在该病例中比较了首台韩国制造的微处理器控制假肢(MPA)和传统的假肢踝关节(CPA),并进行了步态分析和患者长期结果问卷调查。一名 70 岁男性因受伤导致双侧胫骨截肢。在佩戴 MPA 1 个月和 1 年后进行了三维步态分析评估。使用韩国版假肢评估问卷(K-PEQ)评估了满意度、移动能力和疼痛。双侧的时空参数从 CPA 到 1 个月(mMPA)和 1 年(yMPA)都显示出了更高的稳定性。我们观察到单支撑时间增加,步宽减小,并且几乎达到了正常的站立-摆动时间比。在运动学参数中,mMPA 和 yMPA 双侧的踝关节活动范围(ROM)都增加了。不幸的是,MPA 步态在终末站立时踝关节跖屈不足,无法产生上推力量。随着 MPA 适应时间的增加,对称比提高到平衡值。基于问卷的满意度、移动能力和疼痛调查结果非常出色。MPA 有助于 BTA 踝关节的活动能力,而问卷则在各种地形中显示出了良好的满意度和移动能力。