Pressure distribution at the stump/socket interface in transtibial amputees during walking on stairs, slope and non-flat road
Pressure distribution at the stump/socket interface in transtibial amputees during walking on stairs, slope and non-flat road
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DOI：
10.1016/j.clinbiomech.2006.06.004
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发表时间：
2006-12-01
影响因子：
1.8
通讯作者：
Zhang, Ming
中科院分区：
文献类型：
--
作者：
Dou, Peng;Jia, Xiaohong;Zhang, Ming
背景检查残肢/接受腔界面应力的研究仅限于无支撑站立和自然步态，即以舒适的速度在平直的人行道上行走。然而，单侧经胫骨截肢者在楼梯、斜坡和非平坦道路上行走时界面的压力行为尚不清楚。测量了自然行走和在楼梯、斜坡和非平坦道路上行走时多个点的压力分布变化，表示为平均峰值残肢/接受腔界面压力、超过峰值压力90%的平均压力水平、压力超过峰值压力90%的时间以及持续次最大负荷期间的时间-压力积分。与自然步态相比，在台阶和非平坦路面上行走时髌腱上的平均峰值压力和持续次最大负荷显著增加，而在斜坡上和其他测量区域上，髌腱上的平均峰值压力和持续次最大负荷在所有条件下均减小或变化不显著;而且持续次最大负荷的时间段变化显著，除了在上坡时的髌腱和在非平坦道路上的腘区;最后，在持续次最大载荷的时间段内的时间-压力积分变化很大，除了在上坡时的髌腱。自然走动期间的压力特征似乎不能高度预测在楼梯、斜坡和非平坦道路上行走时发生的情况，这导致仅在髌骨肌腱处组织载荷的幅度域显着增加，但几乎在所有测量区域中组织载荷的时间序列发生显着变化。(c)2006爱思唯尔有限公司版权所有。
Background. Studies examining the stump/socket interface stresses have been restricted to unsupported stance and natural gait, i.e. walking at a comfortable speed on flat and straight walkway. However, the pressure behaviour as to the interface in unilateral transtibial amputees during walking on stairs, slope and non-flat road is unclear.Methods. Pressure distribution changes at multiple points, expressed as mean peak stump/socket interface pressure, mean pressure level over 90% of peak pressure, time in which pressure exceeded 90% of peak pressure and time-pressure integral at the period of sustained sub-maximal load, were measured during natural ambulating and walking on stairs, slope and non-flat road.Findings. Compared with natural gait, the mean peak pressure and sustained sub-maximal load increase notably over the patellar tendon during walking on stairs and non-flat road, and however decrease or change insignificantly at the patellar tendon on slope and over other measured areas in all conditions; moreover the time period of sustained sub-maximal load changes remarkably, except over the patellar tendon during walking up slope and over the popliteal area on non-flat road; finally, the time-pressure integral in the time period of sustained sub-maximal load changes considerably, except at the patellar tendon during walking up slope.Interpretation. The pressure characteristics during natural ambulating seem not to be highly predictive of what occurs in the conditions of walking on stairs, slope and non-flat road, which leads to significant increase in amplitude domain of tissue loading only at the patellar tendon, and however to remarkable changes in temporal sequences of tissue (un-)loading almost in all measured regions. (c) 2006 Elsevier Ltd. All rights reserved.