Doerks Frithjof, Gempfer Carina, Reulbach Magnus, Jakubowitz Eike
Laboratory of Biomechanics and Biomaterials, Department of Orthopaedic Surgery, DIAKOVERE Annastift, Hannover Medical School, Anna-von-Borries-Strasse 1-7, 30625 Hannover, Germany.
J Clin Med. 2025 Mar 21;14(7):2140. doi: 10.3390/jcm14072140.
Minor amputations are increasingly relevant due to a growing proportion of lower limb amputations but remain underrepresented in research. These amputations impair mobility due to altered gait, and biomimetic devices could potentially address this issue. Fundamental research is needed to better understand this pathological gait pattern. The aim of this study is to analyse the holistic gait characteristics of the lower extremity during barefoot walking in individuals with different levels of minor amputations for the first time. Eight young to middle-aged subjects with minor foot amputations (four × hallux; four × forefoot) underwent instrumented gait analysis. Kinematic and kinetic data were acquired barefoot at self-selected gait speeds. Individual gait characteristics were considered relative to the physiological gait represented by the 95% confidence interval of ten unimpaired volunteers. Subjects with a minor amputation show reduced walking speed and shorter stride length compared to controls. Sagittal ankle moment and ankle power are lower, with greater deficits in subjects with a forefoot amputation. Proximal joints also show variability, notably reduced knee flexion in subjects with a forefoot amputation and a more flexed hip profile in six subjects. Single-subject frontal plane kinetics also vary. Although the subjects with a hallux amputation exhibit smaller deviations in ankle kinetics than the subjects with a forefoot amputation, proximal joint abnormalities are present across cases. These findings highlight the need for a broad range of care to adequately address individual needs.
由于下肢截肢比例不断增加，小截肢越来越受到关注，但在研究中仍未得到充分体现。这些截肢会因步态改变而影响行动能力，仿生装置可能有助于解决这一问题。需要进行基础研究以更好地理解这种病理性步态模式。本研究的目的是首次分析不同程度小截肢个体在赤足行走时下肢的整体步态特征。八名轻度足部截肢的年轻至中年受试者（四名拇趾截肢；四名前足截肢）接受了仪器化步态分析。在自选步态速度下赤足采集运动学和动力学数据。个体步态特征相对于十名未受损志愿者95%置信区间所代表的生理步态进行考量。与对照组相比，小截肢受试者的步行速度降低，步幅缩短。矢状面踝关节力矩和踝关节功率较低，前足截肢受试者的缺陷更大。近端关节也表现出变异性，特别是前足截肢受试者的膝关节屈曲减少，六名受试者的髋关节轮廓更弯曲。单受试者额面动力学也有所不同。虽然拇趾截肢受试者的踝关节动力学偏差比前足截肢受试者小，但各病例均存在近端关节异常。这些发现凸显了需要广泛的护理以充分满足个体需求。
