Yun Dong Hyuk, Jung Il-Young, Moon Chang Won, Cho Kang Hee
Department of Rehabilitation Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Rehabilitation Medicine, Chungnam National University Sejong Hospital, Sejong, Korea.
Ann Rehabil Med. 2022 Dec;46(6):303-311. doi: 10.5535/arm.22110. Epub 2022 Dec 31.
To evaluate the relationship between femoral muscle volume (FMV) and physiological outcomes after trans-femoral amputations (TFAs) affecting overall locomotor function in patients.
Seven individuals who underwent TFA and had been using a prosthesis participated in this cross-sectional study. Gait and balance were assessed using clinical tests, such as 10-m walk test, 6-minute walk test, Berg Balance Scale, and automatic balance system. Respiratory gas analysis was performed to check oxygen consumption rate. Five participants were evaluated for bilateral FMV by MR imaging and FMV was reconstructed using three-dimentional remodeling.
In five participants, significant differences were found between the non-involved and involved sides in femur length, total FMV, and functional muscle volume (all p<0.01) in all groups except for the hip adductor volume. The %mean difference between the non-involved and involved sides was 30% for femur length, 52.55% for hip flexor volume, 26.55% for hip adductor volume, 51.86% for hip extensor volume, and 60.21% for knee extensor volume. The hip flexor volume to hip extensor volume ratio in the involved limb and oxygen consumption rate during comfortable gait were negatively correlated (r=-0.96, p=0.04).
In individuals who underwent unilateral TFA, hip girdle muscle imbalance in the involved limbs may be associated with oxygen consumption rate while using a prosthesis.
评估股肌体积(FMV)与经股截肢(TFA)后影响患者整体运动功能的生理结果之间的关系。
七名接受TFA并已使用假肢的个体参与了这项横断面研究。使用临床测试评估步态和平衡,如10米步行测试、6分钟步行测试、伯格平衡量表和自动平衡系统。进行呼吸气体分析以检查耗氧率。通过磁共振成像对五名参与者的双侧FMV进行评估,并使用三维重建技术重建FMV。
在五名参与者中,除髋内收肌体积外,所有组的非患侧和患侧在股骨长度、总FMV和功能性肌肉体积方面均存在显著差异(均p<0.01)。非患侧和患侧之间的平均差异百分比在股骨长度方面为30%,髋屈肌体积方面为52.55%,髋内收肌体积方面为26.55%,髋伸肌体积方面为51.86%,膝伸肌体积方面为60.21%。患侧肢体的髋屈肌体积与髋伸肌体积之比与舒适步态期间的耗氧率呈负相关(r=-0.96,p=0.04)。
在接受单侧TFA的个体中,患侧肢体的髋带肌失衡可能与使用假肢时的耗氧率有关。