Center for Limb Loss and Mobility, VA Puget Sound Health Care System, Seattle, WA, United States; Henry M. Jackson Foundation, Bethesda, MD, United States,.
Department of Kinesiology, University of Maryland, College Park, MD, United States; Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, United States.
Gait Posture. 2022 Sep;97:159-164. doi: 10.1016/j.gaitpost.2022.07.257. Epub 2022 Jul 27.
Individuals with lower limb amputation exhibit lower residual limb strength compared to their sound limb. Deficits in residual limb knee flexion and extension strength may impact functional performance during tasks relevant to daily living.
Does knee flexor and extensor strength in the residual limb impact functional outcome measures, such as walking energetics and performance metrics, in individuals with unilateral transtibial amputation?
Fourteen individuals with traumatic unilateral transtibial amputation were recruited for this observational study. Participants completed metabolic testing at three standardized speeds based on leg length, as well maximum isokinetic knee flexion and extension strength for both residual and sound limbs. Participants also completed a series of functional outcome tests, including a two-minute walk test, timed stair ascent test, and four-square step test. Walking energetics (metabolic cost, heart rate, and rating of perceived exertion) and performance metrics were compared to percent deficit of residual limb to sound limb knee flexion and extension muscle strength. A linear regression assessed significant relationships (p < 0.05).
A significant relationship was observed between percent deficit of knee extension strength and heart rate (p = 0.024) at a fast walking speed. Additionally, percent deficit knee flexion strength related to rating of perceived exertion at slow and moderate walking speeds (p = 0.038, p = 0.024). Percent deficit knee extension strength related to two-minute walk time performance (p = 0.035) and percent deficit knee flexion strength related to timed stair ascent time (p = 0.025).
These findings suggest the importance of strength retention of the residual limb knee flexion and extension musculature to improve certain functional outcomes in individuals with unilateral transtibial amputation.
与健肢相比，下肢截肢者的残肢力量较低。残肢膝关节屈伸力量的不足可能会影响与日常生活相关任务的功能表现。
单侧胫骨截肢患者残肢的膝关节屈肌和伸肌力量是否会影响功能性结果测量，如行走能量学和表现指标？
本观察性研究招募了 14 名因创伤导致单侧胫骨截肢的患者。参与者根据腿长以三种标准速度完成代谢测试，以及双侧残肢和健肢的最大等速膝关节屈伸力量测试。参与者还完成了一系列功能性结果测试，包括两分钟步行测试、定时爬楼梯测试和四方步测试。将行走能量学（代谢成本、心率和感知用力程度）和表现指标与残肢至健肢膝关节屈伸肌肉力量的百分比缺陷进行比较。线性回归评估了显著的关系（p<0.05）。
在快速步行速度下，观察到膝关节伸肌力量的百分比缺陷与心率之间存在显著关系（p=0.024）。此外，在慢走和中速行走时，膝关节屈肌力量的百分比缺陷与感知用力程度相关（p=0.038，p=0.024）。膝关节伸肌力量的百分比缺陷与两分钟步行时间表现相关（p=0.035），膝关节屈肌力量的百分比缺陷与定时爬楼梯时间相关（p=0.025）。
这些发现表明，保留单侧胫骨截肢患者残肢膝关节屈伸肌肉力量对于改善某些功能结果非常重要。
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