Boonstra A M, Schrama J M, Eisma W H, Hof A L, Fidler V
Department of Rehabilitation, Groningen University Hospital, The Netherlands.
Arch Phys Med Rehabil. 1996 May;77(5):515-20. doi: 10.1016/s0003-9993(96)90044-1.
To evaluate the gait of transfemoral amputee patients using a prosthesis with a 4-bar linkage knee joint with either a mechanical swing phase control (Otto Bock 3R20) or a pneumatic swing phase control (Tehlin knee).
Randomized cross-over trial.
Rehabilitation Department of a university hospital in The Netherlands.
Twenty-eight subjects with unilateral transfemoral amputation for reasons other than chronic vascular disease; ages between 16 and 65 years and familiar with the use of the Otto Bock 3R20 knee.
a consecutive sample.
The Otto Bock 3R20 was used by the subjects before they entered the study. The patients changed to the Tehlin knee at random either after 1 or 2 assessments with the Otto Bock 3R20.
Temporal and kinematic variables in gait analysis (speed recordings were taken before and after the equipment for the measurements of the other parameters was placed on the patients). Subjective scores for comfortable and fast ambulation were obtained by means of 2 questionnaires. Questionnaire A consisted of multiple choice questions (maximum score: 5) and questions using an 8-point rating scale (maximum score: 7). In questionnaire B, the patient was asked to compare the present prosthesis with the previous one.
Fast walking speed in gait analysis was higher with the Tehlin knee than with the 3R20 (without equipment 95% confidence interval (CI) .02-.09 m/sec, with equipment CI .04-.11), while comfortable walking speed was not higher with the Tehlin knee (without equipment CI -.20-.20 m/sec, with equipment CI .00-.05). Symmetry of walking as regards swing phase duration was closer to 100% with the Tehlin knee than with the 3R20 (comf. walking CI 4% to 19%, fast walking CI 7% to 17%). Knee joint range of motion during swing phase was smaller with the Tehlin knee than with the 3R20 (comf. walking CI 1.8 degrees-8.7 degrees, fast walking CI 2.0 degrees-9.5 degrees). Knee flexion duration during swing phase was shorter for the Tehlin knee than for the 3R20 at fast walking speed (CI 6-46msec), while knee flexion duration from and to 10 degrees flexion was shorter for the Tehlin knee at comfortable speed (CI 18-67msec) and fast speed (CI 20-64msec). In questionnaire A the amputees reported the Tehlin knee to be better for fast walking (part A1 CI .01-.52, part A2 CI .13-.98) and in questionnaire B for both comfortable and fast walking.
使用带有四连杆膝关节且具备机械摆动期控制功能（奥托博克3R20）或气动摆动期控制功能（特林膝关节）的假肢，评估经股截肢患者的步态。
随机交叉试验。
荷兰一家大学医院的康复科。
28名因慢性血管疾病以外的原因进行单侧经股截肢的受试者；年龄在16至65岁之间，且熟悉使用奥托博克3R20膝关节。
连续抽样。
受试者在进入研究前使用奥托博克3R20。在对奥托博克3R20进行1次或2次评估后，患者随机更换为特林膝关节。
步态分析中的时间和运动学变量（在将用于测量其他参数的设备放置在患者身上之前和之后进行速度记录）。通过两份问卷获得舒适和快速行走的主观评分。问卷A由多项选择题（最高分：5分）和使用8分制评分量表的问题（最高分：7分）组成。在问卷B中，要求患者将当前假肢与之前的假肢进行比较。
在步态分析中，使用特林膝关节时的快走速度高于使用3R20时（无设备时95%置信区间（CI）为0.02 - 0.09米/秒，有设备时CI为0.04 - 0.11），而使用特林膝关节时的舒适行走速度并不更高（无设备时CI为 - 0.20 - 0.20米/秒，有设备时CI为0.00 - 0.05）。在摆动期持续时间方面，特林膝关节的行走对称性比3R20更接近100%（舒适行走CI为4%至19%，快速行走CI为7%至17%）。摆动期膝关节活动范围特林膝关节比3R20小（舒适行走CI为1.8度 - 8.7度，快速行走CI为2.0度 - 9.5度）。在快走速度下，特林膝关节摆动期的屈膝持续时间比3R20短（CI为6 - 46毫秒），而在舒适速度和快速速度下，特林膝关节从10度屈膝到伸直以及从伸直到10度屈膝的持续时间更短（舒适速度下CI为18 - 67毫秒，快速速度下CI为20 - 64毫秒）。在问卷A中，截肢者报告特林膝关节在快走方面更好（A1部分CI为0.01 - 0.52，A2部分CI为0.13 - 0.98），在问卷B中，在舒适和快速行走方面均如此。
