Zeng Lingjie, Wang Yitian, Lu Minxun, Nie Yong, Zhou Yong, Min Li, Zhu Xiangdong, Tu Chongqi
National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China.
Sports Institute, Chengdu University of Technology, Chengdu, China.
Medicine (Baltimore). 2025 Apr 11;104(15):e41684. doi: 10.1097/MD.0000000000041684.
Patients with above-knee amputations often experience postoperative secondary diseases in their unaffected leg, including reduced bone density, muscle atrophy, and osteoarthritis. These conditions arise due to altered limb load resulting from the amputation. Assistive walking devices offer additional support and can modify limb load. To assess the impact of different assistive devices on limb load in the unaffected leg, we conducted a study with 13 above-knee amputation patients and thirteen healthy individuals. Participants walked at a self-selected speed while using a prosthetic, single crutch, or double crutches. Gait analysis was performed using Qualisys motion capture and force plates, and kinematic and kinetic data were analyzed using custom OpenSim software. Our results indicate that the prosthetic group closely resembles the healthy group but exhibits differences in knee joint adduction moments and knee joint contact forces. Among the groups, the single-crutch group bears the highest load, while the double-crutches group has the lowest load, even lower than the healthy group. Bio-inspired prosthetics are recommended for long-term use, but optimizing kinematic symmetry through rehabilitation methods and prosthetic modifications is essential. Prolonged use of crutches should be minimized to reduce stress concentration, and resistance training is a suitable strategy.
膝上截肢患者在其未受影响的腿部常常会出现术后继发性疾病,包括骨密度降低、肌肉萎缩和骨关节炎。这些病症是由于截肢导致肢体负荷改变而引起的。辅助行走装置提供额外支撑并可改变肢体负荷。为评估不同辅助装置对未受影响腿部肢体负荷的影响,我们对13名膝上截肢患者和13名健康个体进行了一项研究。参与者在使用假肢、单拐或双拐时以自行选择的速度行走。使用Qualisys运动捕捉系统和测力板进行步态分析,并使用定制的OpenSim软件分析运动学和动力学数据。我们的结果表明,假肢组与健康组非常相似,但在膝关节内收力矩和膝关节接触力方面存在差异。在各小组中,单拐组承受的负荷最高,而双拐组负荷最低,甚至低于健康组。建议长期使用仿生假肢,但通过康复方法和假肢改良来优化运动学对称性至关重要。应尽量减少长期使用拐杖以减轻应力集中,阻力训练是一种合适的策略。