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股骨截肢患者的纵向步态分析:从接受式接受腔假肢到骨整合假肢的单病例报告。

Longitudinal Gait Analysis of a Transfemoral Amputee Patient: Single-Case Report from Socket-Type to Osseointegrated Prosthesis.

机构信息

Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy.

II Orthopaedic and Traumatologic Clinic, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.

出版信息

Sensors (Basel). 2023 Apr 17;23(8):4037. doi: 10.3390/s23084037.

Abstract

The aim of the present case report was to provide a longitudinal functional assessment of a patient with transfemoral amputation from the preoperative status with socket-type prosthesis to one year after the osseointegration surgery. A 44 years-old male patient was scheduled for osseointegration surgery 17 years after transfemoral amputation. Gait analysis was performed through 15 wearable inertial sensors (MTw Awinda, Xsens) before surgery (patient wearing his standard socket-type prosthesis) and at 3-, 6-, and 12-month follow-ups after osseointegration. ANOVA in Statistical Parametric Mapping was used to assess the changes in amputee and sound limb hip and pelvis kinematics. The gait symmetry index progressively improved from the pre-op with socket-type (1.14) to the last follow-up (1.04). Step width after osseointegration surgery was half of the pre-op. Hip flexion-extension range significantly improved at follow-ups while frontal and transverse plane rotations decreased ( < 0.001). Pelvis anteversion, obliquity, and rotation also decreased over time ( < 0.001). Spatiotemporal and gait kinematics improved after osseointegration surgery. One year after surgery, symmetry indices were close to non-pathological gait and gait compensation was sensibly decreased. From a functional point of view, osseointegration surgery could be a valid solution in patients with transfemoral amputation facing issues with traditional socket-type prosthesis.

摘要

本病例报告的目的是对一名股骨截肢患者从术前带义肢接受传统接受腔型假肢到接受骨整合手术后一年的纵向功能评估。一名 44 岁男性患者在股骨截肢后 17 年计划接受骨整合手术。通过 15 个可穿戴惯性传感器(MTw Awinda,Xsens)在术前(患者穿着他的标准接受腔型假肢)和骨整合手术后 3、6 和 12 个月进行步态分析。统计参数映射中的 ANOVA 用于评估截肢和健康肢体髋部和骨盆运动学的变化。步态对称指数从术前接受腔型(1.14)逐渐改善到最后一次随访(1.04)。骨整合手术后的步幅是术前的一半。随访时髋关节屈伸范围显著改善,而额状面和横断面上的旋转减少(<0.001)。骨盆前倾、倾斜和旋转也随时间推移而减少(<0.001)。骨整合手术后的时空和步态运动学得到改善。手术后一年,对称指数接近非病理性步态,步态补偿明显减少。从功能角度来看,骨整合手术可能是传统接受腔型假肢患者的有效解决方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeed/10143735/fd7f252290ac/sensors-23-04037-g001.jpg

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