Functional Evaluation of a Personalized Orthosis for Knee Osteoarthritis: A Motion Capture Analysis
Functional Evaluation of a Personalized Orthosis for Knee Osteoarthritis: A Motion Capture Analysis
复制标题
DOI：
10.1115/1.4051626
复制
发表时间：
2021-12-01
影响因子：
0.9
通讯作者：
Ilies, Horea
中科院分区：
文献类型：
--
作者：
Huber, Martin;Eschbach, Matthew;Ilies, Horea
膝关节骨关节炎(OA)的矫形治疗通常依靠简单的机制，如三点弯曲带和单销铰链。这些常用的支具不能治疗双间隔性膝关节骨性关节炎，没有考虑通常伴随这种情况的肌肉无力，并且使用限制膝关节自然生物力学的铰链。利用一种新颖的、个性化的关节机构与磁流变阻尼器相结合，我们开发并评估了一种试图解决这些缺点的支架。这一过程遵循了三个主要的设计目标：减少整个膝关节的负荷，产生一个支撑性瞬间来帮助大腿肌肉吸收震动，以及最大限度地减少对步态运动学的干扰。两名健康的志愿者被选择在运动捕捉实验室通过步态分析来测试系统的基本功能。将收集的运动学和力板数据与支架上的传感器数据相结合，我们将支架和腿部系统集成到一个反向动力学分析中，从中我们能够评估支架设计对受试者膝关节载荷和力矩的影响。在三个设计目标中：证明了膝关节接触力的减少；观察到了增加的减震，但没有统计学意义；基本保持了自然步态。总而言之，这项研究的结果支持对该系统的临床有效性的进一步研究，并表明本文提出的技术的进一步完善可能会打开通过患者特有的支架进行更有效的骨关节炎治疗的大门。
Orthotic treatments for knee osteoarthritis (OA) typically rely on simple mechanisms such as three-point bending straps and single-pin hinges. These commonly prescribed braces cannot treat bicompartmental knee OA, do not consider the muscle weakness that typically accompanies the condition, and employ hinges that restrict the knee's natural biomechanics. Utilizing a novel, personalized joint mechanism in conjunction with magnetorheological dampers, we have developed and evaluated a brace which attempts to address these shortcomings. This process has respected three principal design goals: reducing the load experienced across the entire knee joint, generating a supportive moment to aid the thigh muscles in shock absorption, and interfering minimally with gait kinematics. Two healthy volunteers were chosen to test the system's basic functionality through gait analysis in a motion capture laboratory. Combining the collected kinematic and force-plate data with data taken from sensors onboard the brace, we integrated the brace and leg system into a single inverse dynamics analysis, from which we were able to evaluate the effect of the brace design on the subjects' knee loads and moments. Of the three design goals: a reduction in knee contact forces was demonstrated; increased shock absorption was observed, but not to statistical significance; and natural gait was largely preserved. Taken in total, the outcome of this study supports additional investigation into the system's clinical effectiveness, and suggests that further refinement of the techniques presented in this paper could open the doors to more effective OA treatment through patient specific braces.