The influence of prosthetic foot alignment on trans-tibial amputee gait
The influence of prosthetic foot alignment on trans-tibial amputee gait
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DOI：
10.3109/03093640309167973
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发表时间：
2003-04
影响因子：
1.5
通讯作者：
A. Fridman;I. Oña;E. Isakov
中科院分区：
文献类型：
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作者：
A. Fridman;I. Oña;E. Isakov
通过义肢医师的主观判断，一个最佳对齐的义肢可以保证最佳的步态质量。然而，截肢者可以适应各种各样的假肢部件的几何构型。研究了经胫骨（TT）假体中足部不同的外旋角度。该研究试图确定(a)足角与其他步态参数之间的关系，以及(b)截肢者对足部过度外旋的补偿模式。八(8)个TT截肢者，安装了相同类型的假体，在行走期间进行了调查。假足向外旋转：最佳角度（10.94°±5.21°），最佳角度再加18°，最佳角度再加36°。借助电子步道进行步态分析。步态速度、站立和摇摆时间以及脚的角度分别在4次跑步中被监测。在三个测试中，步态速度几乎保持不变。当最佳脚角增加36°时，站姿和摇摆时间以及步长都发生了显著变化。这个脚的位置显著影响腿间的时差和腿之间的对称性。在行走过程中，假肢足的外旋因髋关节水平的肢体内旋而减少。由此得出结论，TT截肢者即使在假足过度外旋错位的情况下也能保持有效的步态速度。尽管这种错位会显著影响走路时的其他步态参数，但截肢者能够通过截肢腿髋关节的内部旋转来适应自己。
An optimally aligned prosthesis, as accomplished by the subjective judgment of the prosthetist, guarantees the best quality of gait. Yet, amputees can adapt to a large variety of geometrical configurations of the prosthetic components. Different external rotation angles of the foot in trans-tibial (TT) prostheses were investigated. The study tried to identify (a) the relationship between foot angle and other gait parameters and (b) the compensating pattern of the amputees to excessive external rotation of the foot. Eight (8) TT amputees, fitted with an identical type of prosthesis, were investigated during ambulation. The prosthetic foot was externally rotated as follows: optimal angle (10.94°±5.21°), optimal angle plus another 18°, and optimal angle plus another 36°. Analysis of gait was performed with the aid of an electronic walkway. Speed of gait, stance and swing time, and foot angle were monitored in 4 runs for each of the three foot angles. Speed of gait remained almost constant in the three tests. Stance and swing time, as well as step length, significantly changed when 36° were added to the optimal foot angle. This foot position significantly influenced inter-legs time difference and symmetry between the legs. During ambulation, prosthetic foot external rotation was decreased by internal rotation of the limb at the hip joint level. It is concluded that TT amputees can maintain an efficient speed of gait even when the prosthetic foot is malpositioned in excessive external rotation. Although such a malalignment significantly influences other gait parameters during walking, amputees are able to adapt themselves by internal rotation of the hip joint in the amputated leg.