Hughes L D, Hafesji-Wade A E, Levick J L, Bisele M, Barnett C T
School of Science and Technology, Nottingham Trent University, Nottingham, UK; University Hospitals of Coventry and Warwickshire NHS Trust, UK.
University Hospitals of Derby and Burton NHS Trust, UK.
Clin Biomech (Bristol). 2025 Oct;129:106649. doi: 10.1016/j.clinbiomech.2025.106649. Epub 2025 Aug 12.
Functionally advanced prosthetic ankle-foot and knee components have separately been shown to positively affect obstacle crossing in individuals with a transfemoral amputation. It is unknown, however, what effect combining functionally advanced components has on transfemoral prosthesis users' obstacle-crossing strategies. The study aimed to assess how different knee and ankle-foot prosthetic components influence obstacle-crossing strategies in unilateral transfemoral prosthesis users.
Individuals with a unilateral transfemoral amputation (n = 9) crossed an obstacle (30 cm × 10 cm × 8 cm) placed along an 8.3 m walkway. This was completed in four different prosthetic conditions: a combination of two different knee components (microprocessor and non-microprocessor) with one of two ankle-foot components (rigidly or hydraulically articulating ankles). Full-body kinematics were recorded as participants crossed the obstacles.
Obstacle-crossing strategies were not influenced by the prosthetic component combination. Although small changes were observed in kinematics (joint angles and centre of mass movement) and outcomes such as toe clearance and foot placement, these differences were not statistically significant.
When using different combinations of prosthetic ankle-foot and knee components, lower limb transfemoral prosthesis users make very small changes to movements during obstacle crossing. Obstacle-crossing strategies and outcomes are also not highly influenced by manipulating component use, suggesting relatively high neuromotor flexibility in established unilateral transfemoral prosthesis users when crossing a small obstacle.
功能先进的假肢脚踝和膝盖组件已分别被证明对经股骨截肢者跨越障碍物有积极影响。然而，尚不清楚将功能先进的组件组合起来对经股骨假肢使用者的障碍物跨越策略有何影响。本研究旨在评估不同的膝盖和脚踝假肢组件如何影响单侧经股骨假肢使用者的障碍物跨越策略。
单侧经股骨截肢者（n = 9）跨越沿8.3米走道放置的障碍物（30厘米×10厘米×8厘米）。这在四种不同的假肢条件下完成：两种不同的膝盖组件（微处理器和非微处理器）与两种脚踝组件之一（刚性或液压关节脚踝）的组合。当参与者跨越障碍物时记录全身运动学数据。
障碍物跨越策略不受假肢组件组合的影响。尽管在运动学（关节角度和质心运动）以及诸如脚趾间隙和足部放置等结果方面观察到了微小变化，但这些差异在统计学上并不显著。
当使用不同组合的假肢脚踝和膝盖组件时，下肢经股骨假肢使用者在跨越障碍物时的动作变化非常小。通过操控组件使用，障碍物跨越策略和结果也不会受到很大影响，这表明在既定的单侧经股骨假肢使用者跨越小障碍物时具有相对较高的神经运动灵活性。
