Cortés A, Viosca E, Hoyos J V, Prat J, Sánchez-Lacuesta J
Institute of Biomechanics of Valencia (IBV), Parque Tecnológico de Valencia, Spain.
Prosthet Orthot Int. 1997 Dec;21(3):168-74. doi: 10.3109/03093649709164550.
The great diversity of prosthetic mechanisms available nowadays leads to the question of which type of artificial foot would be the most advisable for a particular person. To answer correctly, it is necessary to establish, in an objective way, the performance of each type of prosthetic mechanism. This knowledge is obtained by means of the study of the subject-prosthesis interaction, both in static and dynamic conditions. This paper, based on the analysis of 8 trans-tibial (TT) amputees, presents a quantitative method for the study of human gait which allows the determination of the influence of four different prosthetic ankle-foot mechanisms (SACH, Single-axis, Greissinger and Dynamic) on gait. To do this, 1341 gait trials at different cadences were analysed (383 with normal subjects and 958 with amputees, using the four prosthetic feet under study). From all the variables available for study only those which offered interpretable clinical information were chosen for analysis. A total of 18 variables (kinetic, kinematic and time-related) were selected. A covariance analysis (ANOVA) of these variables was made, which showed that the factors influencing TT amputee gait were, in order of importance, cadence and leg studied (sound or prosthetic), inter-individual variability and, finally, the prosthetic mechanism used. When looking at the performance during gait of the 4 prosthetic mechanisms studied it can be observed that there are similarities in the kinetic study between SACH and Dynamic feet on one hand and Single-axis and Greissinger feet on the other. These results seem to support the classification criteria of articulated and non-articulated prosthetic mechanisms.
如今，可用的假肢机制种类繁多，这就引发了一个问题：对于特定的人来说，哪种类型的假脚最为合适。为了正确回答这个问题，有必要客观地确定每种假肢机制的性能。这种知识是通过研究受试者与假肢在静态和动态条件下的相互作用获得的。本文基于对8名经胫骨截肢者的分析，提出了一种研究人类步态的定量方法，该方法能够确定四种不同的假肢踝足机制（静态踝关节假肢、单轴假肢、格赖辛格假肢和动态假肢）对步态的影响。为此，分析了1341次不同步频的步态试验（383次针对正常受试者，958次针对截肢者，使用了所研究的四种假脚）。从所有可供研究的变量中，仅选择那些能提供可解释临床信息的变量进行分析。总共选择了18个变量（动力学、运动学和时间相关变量）。对这些变量进行了协方差分析（方差分析），结果表明，影响经胫骨截肢者步态的因素按重要性排序依次为步频、所研究的腿（健全腿或假肢腿）、个体间差异，最后是所使用的假肢机制。在观察所研究的4种假肢机制在步态中的表现时，可以发现，一方面，静态踝关节假肢和动态假肢在动力学研究方面存在相似之处；另一方面，单轴假肢和格赖辛格假肢也有相似之处。这些结果似乎支持了有关铰接式和非铰接式假肢机制的分类标准。
