Compensatory mechanism involving the knee joint of the intact limb during gait in unilateral below-knee amputees
Compensatory mechanism involving the knee joint of the intact limb during gait in unilateral below-knee amputees
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DOI：
10.1016/j.gaitpost.2007.12.073
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发表时间：
2008-08-01
期刊：
影响因子：
2.4
通讯作者：
Andre, J. -M.
中科院分区：
文献类型：
--
作者：
Beyaert, C.;Grumillier, C.;Andre, J. -M.
本研究评估了假体错位引起的不舒适步态时膝关节动力学的不对称性，以进一步论证完整肢体膝关节在步态过程中的代偿功能。对 15 名健康受试者和 17 名单侧胫骨截肢者 (TTA) 进行三维步态分析，包括站立阶段开始时的膝关节运动学和动力学，在三种假肢对准条件下以自选速度行走：初始对准 (IA)；初始对准 (IA)；初始对准通过施加在塔上的 6 度内旋 (IR) 或 6 度外旋 (ER) 进行更改。患者报告在 IA 状态下步态最舒适，而不适主要在 IR 状态下。与假肢和对照肢体相比，完整肢体在动力阶段 K0-K2 的最大膝关节屈曲和膝关节总做功显着更高。在完整肢体中，这些变量在 IR 条件下的值显着高于 IA 条件（+10-35%，p < 0.05），而这些变量在假肢条件下没有变化。在经胫骨截肢者中，通过内部旋转假足引起不舒服的步态并没有改变假肢的膝盖动力学，这表明存在保护机制。完整肢体的膝关节动力学确实发生了变化，这表明存在补偿机制。 (c) 2008 Elsevier B.V. 保留所有权利。
This study evaluated the asymmetry of knee kinetics during uncomfortable gait induced by prosthesis misalignment to further demonstrate the compensatory function of the knee joint of the intact limb during gait. Three-dimensional gait analysis including knee kinematics and kinetics at the beginning of stance phase was conducted in 15 healthy subjects and 17 unilateral trans-tibial amputees (TTA) walking at self-selected speed in three conditions of prosthetic alignment: initial alignment (IA); initial alignment altered either by 6 degrees of internal rotation (IR) or by 6 degrees of external rotation (ER) applied on the pylon. Patients reported best comfort of gait in IA condition and discomfort mainly in IR condition. Maximum knee flexion and knee total work at power phases K0-K2 were significantly higher in intact limbs compared to prosthetic and control limbs. In intact limbs, these variables had significantly higher values (+10-35%, p < 0.05) in IR condition than IA condition whereas these were not altered across conditions in prosthetic limbs. In trans-tibial amputees, inducing uncomfortable gait by internally rotating the prosthetic foot did not alter the knee kinetics of the prosthetic limb, which suggests a protective mechanism. Knee kinetics of the intact limb did alter, which suggests a compensatory mechanism. (c) 2008 Elsevier B.V. All rights reserved.