Zeng Lingjie, He Xuanhong, Lu Minxun, Nie Yong, Zhu Xiangdong, Tu Chongqi
National Engineering Research Center for Biomaterials, Sichuan University, Chengdu Sichuan, 610064, P. R. China.
College of Physical Education, Chengdu University of Technology, Chengdu Sichuan, 610059, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2025 Jun 15;39(6):729-734. doi: 10.7507/1002-1892.202502032.
To explore the feasibility of using biomechanical indicators as supplementary evaluation to the Musculoskeletal Tumor Society Scoring System (MSTS) for amputee patients.
Twenty-four patients who underwent hemipelvectomy between September 2018 and January 2025 were enrolled. There were 15 males and 9 females with an average age of 61.4 years (range, 45-76 years). Participants performed gait tests at self-selected speeds using three assistive devices (prosthesis, single crutch, and double crutches). Motion data were analyzed using a customized OpenSim model. Biomechanical indicators of the intact limb exhibiting common characteristics were screened through correlation and sensitivity analyses. Test-retest reliability [interclass correlation coefficient (ICC)] of selected parameters was assessed to evaluate their potential as MSTS score supplements.
All biomechanical indicators showed significant positive correlations with MSTS scores across assistive devices ( <0.05). Seven indicators demonstrated |Pearson correlation coefficients|>0.8, including walking speed, maximum hip angle, maximum hip moment, peak hip flexion moment, peak hip extension moment, hip flexion impulse, and hip extension impulse. Among these, maximum hip moment, hip flexion impulse, and hip extension impulse exhibited significant between-group differences in adjacent MSTS levels ( <0.05), indicating high sensitivity, along with excellent test-retest reliability (ICC>0.74, <0.01).
Biomechanical indicators statistically qualify as potential supplements to MSTS scoring. Maximum hip moment, hip flexion impulse, and hip extension impulse demonstrate particularly high sensitivity to MSTS score variations.
探讨将生物力学指标作为截肢患者肌肉骨骼肿瘤学会评分系统（MSTS）补充评估指标的可行性。
纳入2018年9月至2025年1月期间接受半骨盆切除术的24例患者。其中男性15例，女性9例，平均年龄61.4岁（范围45 - 76岁）。参与者使用三种辅助器械（假肢、单拐和双拐）以自选速度进行步态测试。使用定制的OpenSim模型分析运动数据。通过相关性和敏感性分析筛选出健侧肢体具有共同特征的生物力学指标。评估所选参数的重测信度[组内相关系数（ICC）]，以评估其作为MSTS评分补充指标的潜力。
所有生物力学指标在不同辅助器械下均与MSTS评分呈显著正相关（<0.05）。七个指标的|皮尔逊相关系数|>0.8，包括步行速度、最大髋关节角度、最大髋关节力矩、髋关节屈曲峰值力矩、髋关节伸展峰值力矩、髋关节屈曲冲量和髋关节伸展冲量。其中，最大髋关节力矩、髋关节屈曲冲量和髋关节伸展冲量在相邻MSTS水平间存在显著组间差异（<0.05），表明敏感性高，同时重测信度良好（ICC>0.74，<0.01）。
生物力学指标在统计学上有资格作为MSTS评分的潜在补充指标。最大髋关节力矩、髋关节屈曲冲量和髋关节伸展冲量对MSTS评分变化表现出特别高的敏感性。
