de Vries J
Rehabilitation Center Het Roessingh, Enschede, The Netherlands.
J Rehabil Res Dev. 1995 Feb;32(1):36-42.
The purpose of this article is to inform clinicians of the relevant knowledge gained from research in the field of prosthetics. From a biomechanical point of view, clinicians need relevant knowledge in order to properly prescribe a lower limb prosthesis, including prosthetic components. In this context, and due to the lack of data regarding their utility, a strength-weakness analysis of 8 types of 4-bar linkage knee mechanisms has been carried out. Free-moving knees are intrinsically stable in the stance phase of walking when the O degrees center of rotation is behind the femur head to heel line. This was found in 5 of the 8 knees. Furthermore, bending the knee at toe-off requires force. The hip-flexion-torque required is smaller when the O degrees center of rotation is closer to the femur head to toe line and is dependent on the measure of axial load. Comparatively, however, much energy is usually still necessary. This can be improved. The maximal axial residual limb load, the maximal hip-moment, and the energy required are, on investigation of the knees, approximately the same in relation to the walking speed during the swing phase of gait. Friction influences the swing characteristics of the prosthetic lower limb considerably. In this context, little is yet known about swing phase knee control units. The present 4-bar linkage knees-with-lock are a derivation of the free-moving knees. Their movement characteristics, and often heavy construction, are of no relevance when walking with a fixed knee. In proportion, much energy is required. Therefore, there is a demand for a simple knee mechanism that moves freely during the swing phase, locks at the beginning of the stance phase, and unlocks at the end of it.
本文旨在向临床医生介绍假肢领域研究中获得的相关知识。从生物力学角度来看,临床医生需要相关知识以便正确开具下肢假肢处方,包括假肢组件。在此背景下,由于缺乏关于其效用的数据,对8种四连杆膝关节机构进行了优缺点分析。当0度旋转中心位于股骨头至足跟线后方时,自由活动膝关节在步行支撑期本质上是稳定的。在8个膝关节中有5个是这种情况。此外,在足趾离地时弯曲膝关节需要用力。当0度旋转中心更靠近股骨头至足趾线时,所需的髋部屈曲扭矩较小,并且取决于轴向负荷的大小。然而,相比之下,通常仍需要大量能量。这是可以改进的。在对膝关节进行研究时,最大轴向残肢负荷、最大髋部力矩和所需能量在步态摆动期与步行速度的关系上大致相同。摩擦力对假肢下肢的摆动特性有很大影响。在这方面,关于摆动期膝关节控制单元的了解还很少。目前的带锁四连杆膝关节是自由活动膝关节的一种衍生形式。当膝关节固定行走时,它们的运动特性以及通常较重的结构并无关联。相应地,需要大量能量。因此,需要一种在摆动期自由移动、在支撑期开始时锁定并在支撑期结束时解锁的简单膝关节机构。