Parr T E, Farrokhi S, Hendershot B D, Butowicz C M
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA; Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, VA, USA.
Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Chapman University, Irvine, CA, USA.
Clin Biomech (Bristol). 2025 Aug;128:106623. doi: 10.1016/j.clinbiomech.2025.106623. Epub 2025 Jul 18.
Individuals with lower-limb amputation commonly experience low back pain, which may be associated with altered movement strategies or impaired trunk control during activities of daily living, such as sit-to-stand. The aim of this study was to assess, using wearable sensors, sit-to-stand performance and trunk movement variations of persons with transtibial amputation, with and without low back pain.
Fifty-eight persons with unilateral transtibial amputation (28 with and 30 without low back pain) performed five sit-to-stand trials while wearing two inertial measurement units affixed to the thigh and sternum. Sit-to-stand completion time, as well as triaxial root mean square of acceleration and triaxial variance of jerk (calculated from the trunk sensor), were compared between groups.
There was no difference in completion time between groups (12.1 ± 3.8 vs 11.6 ± 2.9 s; p = 0.54), but there was greater movement variation for persons with vs. without low back pain in the medial-lateral direction (p = 0.042), including root mean square of acceleration for sit-to-stand (p = 0.049) and variance of jerk for sit-to-stand (p = 0.012) and stand-to-sit (p = 0.018).
This study indicates that accelerometer-based metrics of trunk control are able to differentiate between persons with transtibial amputation with and without low back pain, with the pain group demonstrating decreased control. The use of sensors may help guide in-clinic or at-home movement retraining or device prescriptions for improving trunk control during dynamic activities, such as sit-to-stand.
下肢截肢患者常经历腰痛，这可能与日常生活活动（如从坐到站）中运动策略改变或躯干控制受损有关。本研究的目的是使用可穿戴传感器评估经胫截肢患者在有和没有腰痛情况下从坐到站的表现以及躯干运动变化。
58名单侧经胫截肢患者（28名有腰痛，30名无腰痛）在大腿和胸骨上佩戴两个惯性测量单元的情况下进行5次从坐到站试验。比较两组之间从坐到站的完成时间以及加速度的三轴均方根和急动度的三轴方差（由躯干传感器计算得出）。
两组之间的完成时间没有差异（12.1±3.8秒对11.6±2.9秒；p = 0.54），但有腰痛的患者与无腰痛的患者相比，在内外侧方向上的运动变化更大（p = 0.042），包括从坐到站的加速度均方根（p = 0.049）以及从坐到站和从站到坐的急动度方差（p = 0.012和p = 0.018）。
本研究表明，基于加速度计的躯干控制指标能够区分有和没有腰痛的经胫截肢患者，疼痛组表现出控制能力下降。使用传感器可能有助于指导临床或家庭运动再训练或设备处方，以改善动态活动（如从坐到站）期间的躯干控制。
