Bergmann G, Kölbel R, Rauschenbach N, Rohlmann A
Z Orthop Ihre Grenzgeb. 1978 Feb;116(1):106-13.
Partial weight bearing is frequently prescribed but cannot be controlled adequately. In a previous paper the change of forces at the hip joint as effected by a one sided cane was determined by instrumentation of the cane and a mechanical analysis of gait on a walkway. In the present study we looked at the conditions for control of partial weightbearing when two forearm crutches are used. Instrumented crutches and a forceplate were used. In walking with two forearm crutches the total of the ground reaction forces and the force pattern differ from those in free walking. The total of two crutch forces plus the force at the leg with partial weightbearing exceeds that caused by body weight alone. This is due to mass accelerations in a changed gait pattern. When the maximal leg force is reduced from 100% body weight to zero, the additional dynamic forces exceed those caused by body weight alone by 4%-19%. Only 2% of the additional dynamic forces act on the controlateral crutch while the rest is transmitted through the ipsilateral crutch. The crutch force pattern on the ipsilateral side depends more on individual gait characteristics than does that on the controlateral side. Load reduction is more pronounced in the late stages of the stand phase than in the early ones.
部分负重是常见的医嘱，但难以得到充分控制。在之前的一篇论文中，通过在拐杖上安装仪器并对人行道上的步态进行力学分析，确定了单侧拐杖对髋关节受力的影响。在本研究中，我们研究了使用双前臂拐杖时控制部分负重的条件。使用了装有仪器的拐杖和测力板。使用双前臂拐杖行走时，地面反作用力的总和及力的模式与自由行走时不同。双拐杖力的总和加上部分负重侧腿部的力超过了仅由体重产生的力。这是由于步态模式改变时的质量加速度所致。当最大腿部力量从体重的100%降至零时，额外的动力超过仅由体重产生的力4% - 19%。仅2%的额外动力作用于对侧拐杖，其余则通过同侧拐杖传递。同侧拐杖的力模式比另一侧更依赖于个体的步态特征。站立期后期的负荷减轻比早期更明显。
