Shotande Monique O, Veirs Kimberly P, Day Jonathan D, Ertl William J J, Fagg Andrew H, Dionne Carol P
School of Computer Science, University of Oklahoma, Norman, OK, United States.
Department of Physical Therapy, Oklahoma City University, Oklahoma City, OK, United States.
Front Rehabil Sci. 2022 May 6;3:848657. doi: 10.3389/fresc.2022.848657. eCollection 2022.
The aim of osteomyoplastic transfemoral amputation (OTFA) is to produce sustained, robust prosthetic gait performance by residuum reconstructing. A better understanding of residuum-socket interface pressures (RSI) and residuum muscle activation should uniquely reveal gait stability to better inform long-term rehabilitation goals.
The objectives of this study are to characterize RSI pressures and residuum muscle activation in men with OTFA while walking at two speeds and compare temporospatial muscle activation with intact controls.
In this study, we observed and compared healthy men with OTFA and controls during 2-min gait trials at brisk and self-paced speeds, two visits, and 1 year apart. RSI pressures and hip adductors, hamstrings, and quadriceps activation were recorded for those with OTFA. OTFA temporospatial muscle activation patterns were compared with the controls. Within the extracted strides, heel-strike and toe-off events and EMG activation peak times were characterized and compared. Peak times for pressure and EMG activity were examined in individual muscles and antagonist muscles of residual and intact limbs.
Six men with OTFA exhibited adductor, hamstring, and quadriceps co-contraction within intact and residual limbs, regardless of walking speed or trial. Co-contraction within their intact limb occurred throughout the gait cycle. Within the residuum, co-contraction occurred during weight transference. The 75% most likely RSI peaks occurred during stance. EMG peaks were 75% most likely to occur during early stance, terminal stance-initial swing, and terminal swing.
Participants with OTFA demonstrated adductors-hamstrings-quadriceps co-contraction in the intact thigh and residuum with corresponding RSI pressure increase, primarily during transitions between stance and swing, indicating gait instability, demonstrating the need to explicitly address these deficits continuously in rehabilitation and wellness settings.
骨成形性经股骨截肢术（OTFA）的目的是通过残肢重建实现持续、稳健的假肢步态表现。更好地了解残肢 - 接受腔界面压力（RSI）和残肢肌肉激活情况，应能独特地揭示步态稳定性，从而为长期康复目标提供更充分的信息。
本研究的目的是描述接受OTFA的男性在两种速度行走时的RSI压力和残肢肌肉激活情况，并将时空肌肉激活情况与健全对照组进行比较。
在本研究中，我们观察并比较了接受OTFA的健康男性和对照组在轻快和自定速度下进行的2分钟步态试验，试验分两次进行，间隔1年。记录接受OTFA者的RSI压力以及髋内收肌、腘绳肌和股四头肌的激活情况。将OTFA的时空肌肉激活模式与对照组进行比较。在提取的步幅内，对足跟触地和足尖离地事件以及肌电图激活峰值时间进行特征描述和比较。检查了残肢和健全肢体的单个肌肉以及拮抗肌的压力和肌电图活动峰值时间。
六名接受OTFA的男性在健全肢体和残肢内均表现出内收肌、腘绳肌和股四头肌的共同收缩，无论行走速度或试验情况如何。其健全肢体的共同收缩在整个步态周期中均有发生。在残肢内，共同收缩发生在体重转移期间。75%最可能出现的RSI峰值出现在站立期。肌电图峰值75%最可能出现在站立前期、站立末期 - 摆动初期和摆动末期。
接受OTFA的参与者在健全大腿和残肢内表现出内收肌 - 腘绳肌 - 股四头肌共同收缩，同时RSI压力相应增加，主要发生在站立和摆动之间的过渡阶段，表明步态不稳定，这表明在康复和健康环境中需要持续明确地解决这些缺陷。
