Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking.
Prosthetic ankle push-off work reduces metabolic rate but not collision work in non-amputee walking.
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DOI：
10.1038/srep07213
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发表时间：
2014-12-03
影响因子：
4.6
通讯作者：
Collins SH
中科院分区：
文献类型：
--
作者：
Caputo JM;Collins SH
单侧膝下截肢者在行走过程中比非截肢者消耗更多的能量，并表现出受影响肢体的推离功减少和髋关节功增加。简单的步行动态模型提出了一种可能的解决方案，预测增加假肢踝关节推离应减少领先的肢体碰撞，从而减少整体能源需求。我们对这一想法进行了严格的实验测试，其中踝足假肢的蹬离功从正常水平的一半到两倍递增变化，同时模拟截肢的受试者以1.25 m·s-1的速度在跑步机上行走。 增加假体推出显著降低代谢能量消耗，在最大假体工作时减少14%。然而，与模型预测相反，碰撞损失没有变化，而挥杆开始时髋关节的工作减少了。这表明动力踝蹬离主要通过其他机制减少行走努力，例如辅助腿部摆动，使用更完整的神经肌肉模型可以更好地理解。
Individuals with unilateral below-knee amputation expend more energy than non-amputees during walking and exhibit reduced push-off work and increased hip work in the affected limb. Simple dynamic models of walking suggest a possible solution, predicting that increasing prosthetic ankle push-off should decrease leading limb collision, thereby reducing overall energy requirements. We conducted a rigorous experimental test of this idea wherein ankle-foot prosthesis push-off work was incrementally varied in isolation from one-half to two-times normal levels while subjects with simulated amputation walked on a treadmill at 1.25 m·s−1. Increased prosthesis push-off significantly reduced metabolic energy expenditure, with a 14% reduction at maximum prosthesis work. In contrast to model predictions, however, collision losses were unchanged, while hip work during swing initiation was decreased. This suggests that powered ankle push-off reduces walking effort primarily through other mechanisms, such as assisting leg swing, which would be better understood using more complete neuromuscular models.
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