Jonkergouw Niels, Prins Maarten R, Donse Daniël, van der Wurff Peter, van Dieën Jaap H, Buis Arjan, Houdijk Han
Department of Orthopaedic Technology, Military Rehabilitation Centre Aardenburg, Korte Molenweg 3, 3941 PW, Doorn, The Netherlands.
Department of Human Movement Sciences, University Medical Centre Groningen, Groningen, The Netherlands.
Sci Rep. 2024 Apr 27;14(1):9725. doi: 10.1038/s41598-024-60353-7.
Transtibial prosthetic users do often struggle to achieve an optimal prosthetic fit, leading to residual limb pain and stump-socket instability. Prosthetists face challenges in objectively assessing the impact of prosthetic adjustments on residual limb loading. Understanding the mechanical behaviour of the pseudo-joint formed by the residual bone and prosthesis may facilitate prosthetic adjustments and achieving optimal fit. This study aimed to assess the feasibility of using B-mode ultrasound to monitor in vivo residual bone movement within a transtibial prosthetic socket during different stepping tasks. Five transtibial prosthesis users participated, and ultrasound images were captured using a Samsung HM70A system during five dynamic conditions. Bone movement relative to the socket was quantified by tracking the bone contour using Adobe After-Effect. During the study a methodological adjustment was made to improve data quality, and the first two participants were excluded from analysis. The remaining three participants exhibited consistent range of motion, with a signal to noise ratio ranging from 1.12 to 2.59. Medial-lateral and anterior-posterior absolute range of motion varied between 0.03 to 0.88 cm and 0.14 to 0.87 cm, respectively. This study demonstrated that it is feasible to use B-mode ultrasound to monitor in vivo residual bone movement inside an intact prosthetic socket during stepping tasks.
经胫骨假肢使用者常常难以实现假肢的最佳适配，从而导致残肢疼痛和残肢与接受腔之间的不稳定。假肢师在客观评估假肢调整对残肢负荷的影响方面面临挑战。了解由残骨和假肢形成的假关节的力学行为可能有助于假肢调整并实现最佳适配。本研究旨在评估使用B型超声监测经胫骨假肢接受腔内残骨在不同步行任务期间的体内运动的可行性。五名经胫骨假肢使用者参与了研究，在五种动态条件下使用三星HM70A系统采集超声图像。通过使用Adobe After-Effect跟踪骨轮廓来量化骨相对于接受腔的运动。在研究过程中进行了方法学调整以提高数据质量，前两名参与者被排除在分析之外。其余三名参与者表现出一致的运动范围，信噪比在1.12至2.59之间。内侧-外侧和前后绝对运动范围分别在0.03至0.88厘米和0.14至0.87厘米之间变化。本研究表明，在步行任务期间使用B型超声监测完整假肢接受腔内残骨的体内运动是可行的。
