De Marchis Cristiano, Ranaldi Simone, Varrecchia Tiwana, Serrao Mariano, Castiglia Stefano Filippo, Tatarelli Antonella, Ranavolo Alberto, Draicchio Francesco, Lacquaniti Francesco, Conforto Silvia
Department of Industrial, Electronics and Mechanical Engineering, Roma Tre University, Rome, Italy.
Department of Engineering, University of Messina, Messina, Italy.
Front Rehabil Sci. 2022 Mar 17;3:804746. doi: 10.3389/fresc.2022.804746. eCollection 2022.
Prosthetic gait implies the use of compensatory motor strategies, including alterations in gait biomechanics and adaptations in the neural control mechanisms adopted by the central nervous system. Despite the constant technological advancements in prostheses design that led to a reduction in compensatory movements and an increased acceptance by the users, a deep comprehension of the numerous factors that influence prosthetic gait is still needed. The quantitative prosthetic gait analysis is an essential step in the development of new and ergonomic devices and to optimize the rehabilitation therapies. Nevertheless, the assessment of prosthetic gait is still carried out by a heterogeneous variety of methodologies, and this limits the comparison of results from different studies, complicating the definition of shared and well-accepted guidelines among clinicians, therapists, physicians, and engineers. This perspective article starts from the results of a project funded by the Italian Worker's Compensation Authority (INAIL) that led to the generation of an extended dataset of measurements involving kinematic, kinetic, and electrophysiological recordings in subjects with different types of amputation and prosthetic components. By encompassing different studies published along the project activities, we discuss the specific information that can be extracted by different kinds of measurements, and we here provide a methodological perspective related to multimodal prosthetic gait assessment, highlighting how, for designing improved prostheses and more effective therapies for patients, it is of critical importance to analyze movement neural control and its mechanical actuation as a whole, without limiting the focus to one specific aspect.
假肢步态意味着使用补偿性运动策略,包括步态生物力学的改变以及中枢神经系统所采用的神经控制机制的适应性变化。尽管假肢设计技术不断进步,使得补偿性运动减少且用户接受度提高,但仍需要深入了解影响假肢步态的众多因素。定量假肢步态分析是开发新型人体工程学设备以及优化康复治疗的关键步骤。然而,目前对假肢步态的评估仍采用各种不同的方法,这限制了不同研究结果之间的比较,使得临床医生、治疗师、内科医生和工程师之间难以制定共同认可且广泛接受的指导方针。这篇观点文章基于意大利工伤赔偿管理局(INAIL)资助的一个项目成果展开,该项目生成了一个扩展数据集,包含不同类型截肢和假肢组件受试者的运动学、动力学及电生理记录测量数据。通过纳入项目活动期间发表的不同研究,我们讨论了不同类型测量所能提取的具体信息,并在此提供了一个与多模式假肢步态评估相关的方法学视角,强调了对于设计更优假肢和为患者提供更有效治疗而言,将运动神经控制及其机械驱动作为一个整体进行分析至关重要,而不应局限于某一个特定方面。