穿臂式假肢的使用会影响上肢的运动学和动力学。
Transhumeral prosthesis use affects upper body kinematics and kinetics.
机构信息
Department of Biomedical Engineering University of Utah, 36 S Wasatch Dr, Salt Lake City, UT 84112, USA; Department of Orthopaedics University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
Department of Physical Therapy and Athletic Training University of Utah, 520 Wakara Way, Salt Lake City, UT 84108, USA; College of Health, Human Services & Nursing California State University, 1000 E. Victoria Street, Carson, CA 90747, USA.
出版信息
Gait Posture. 2024 Jul;112:59-66. doi: 10.1016/j.gaitpost.2024.05.007. Epub 2024 May 11.
BACKGROUND
Transhumeral (TH) limb loss leads to loss of body mass and reduced shoulder range of motion. Despite most owning a prosthesis, prosthesis abandonment is common. The consequence of TH limb loss and prosthesis use and disuse during gait may be compensation in the upper body, contributing to back pain or injury. Understanding the impact of not wearing a TH prosthesis on upper body asymmetries and spatial-temporal aspects of gait will inform how TH prosthesis use and disuse affects the body.
RESEARCH QUESTION
Does TH limb loss alter upper body asymmetries and spatial-temporal parameters during gait when wearing and not wearing a prosthesis compared to able-bodied controls?
METHODS
Eight male TH limb loss participants and eight male control participants completed three gait trials at self-selected speeds. The TH limb loss group performed trials with and without their prosthesis. Arm swing, trunk angular displacement, trunk-pelvis moment, and spatial-temporal aspects were compared using non-parametric statistical analyses.
RESULTS
Both TH walking conditions showed greater arm swing in the intact limb compared to the residual (p≤0.001), resulting in increased asymmetry compared to the control group (p≤0.001). Without the prosthesis, there was less trunk flexion and lateral flexion compared to the control group (p≤0.001). Maximum moments between the trunk and pelvis were higher in the TH group than the control group (p≤0.05). Spatial-temporal parameters of gait did not differ between the control group and either TH limb loss condition.
SIGNIFICANCE
Prosthesis use affects upper body kinematics and kinetics, but does not significantly impact spatial-temporal aspects of gait, suggesting these are compensatory actions. Wearing a prosthesis helps achieve more normative upper body kinematics and kinetics than not wearing a prosthesis, which may help limit back pain. These findings emphasize the importance of encouraging at least passive use of prostheses for individuals with TH limb loss.
背景
肱骨截肢（TH）导致体重减轻和肩部活动范围减小。尽管大多数人都有假肢，但假肢的抛弃很常见。在步态中，TH 肢体丧失和假肢使用与不用的后果可能会导致上半身代偿，从而导致背痛或受伤。了解不佩戴 TH 假肢对上半身不对称和步态时空参数的影响，将有助于了解 TH 假肢使用和不用对身体的影响。
研究问题
与健全对照组相比，TH 肢体丧失患者佩戴和不佩戴假肢时，步态中上半身不对称和时空参数是否会发生变化？
方法
8 名男性 TH 肢体丧失患者和 8 名男性对照组参与者以自定速度完成了 3 次步态试验。TH 肢体丧失组在佩戴和不佩戴假肢的情况下进行了试验。使用非参数统计分析比较手臂摆动、躯干角度位移、躯干-骨盆力矩和时空参数。
结果
TH 行走两种情况下，健肢的手臂摆动都比残肢大（p≤0.001），与对照组相比，不对称性增加（p≤0.001）。不佩戴假肢时，与对照组相比，躯干前屈和侧屈减少（p≤0.001）。与对照组相比，TH 组躯干与骨盆之间的最大力矩更高（p≤0.05）。对照组与 TH 肢体丧失两种情况之间的步态时空参数没有差异。
意义
假肢的使用会影响上半身运动学和动力学，但对步态的时空参数没有显著影响，这表明这些是代偿性动作。佩戴假肢比不佩戴假肢更有助于实现更正常的上半身运动学和动力学，这可能有助于减轻背痛。这些发现强调了鼓励至少被动使用假肢对 TH 肢体丧失患者的重要性。
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