Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments
Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments
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DOI：
10.1016/j.jbiomech.2013.12.011
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发表时间：
2014-03-21
影响因子：
2.4
通讯作者：
Wilken, Jason M.
中科院分区：
文献类型：
--
作者：
Beltran, Eduardo J.;Dingwell, Jonathan B.;Wilken, Jason M.
了解下肢截肢如何影响行走稳定性，特别是在不稳定的环境中，对于制定有效的干预措施以防止福尔斯至关重要。本研究量化了创伤性单侧经胫骨截肢（TTA）的年轻个体和年轻健全个体（AB）的内外侧稳定性边缘（MOS）和MOS子成分。13个AB和9个TTA在三种测试条件中的每一种下在计算机辅助康复ENAMINATION（CAREN）系统中完成了5个3分钟的步行试验：无扰动、平台的伪随机中侧平移和视野的伪随机中侧平移。与未扰动试验相比，TTA在平台和视野扰动期间表现出平均MOS和MOS变异性增加（p < 0.010）。AB在视野扰动期间表现出增加的平均MOS，并且在平台和视野扰动期间表现出增加的MOS变异性（p < 0.050）。在平台扰动期间，TTA的平均MOS值显著大于AB（p < 0.050）和MOS变异性（p < 0.050）;初始接触时质心（COM）和支撑基底之间的横向距离的变异性（p < 0.005）; COM运动范围的平均值和变异性（p < 0.010）;以及COM峰值速度的变异性（p < 0.050）。通过平均MOS和MOS变异性确定，经胫骨截肢的年轻和其他健康个体在不受干扰和视觉干扰的行走过程中实现了与健全人相似的侧向稳定性。然而，基于MOS的平均值和变异性，单侧经胫骨截肢显示在平台扰动期间影响了外侧行走稳定性。爱思唯尔有限公司出版
Understanding how lower-limb amputation affects walking stability, specifically in destabilizing environments, is essential for developing effective interventions to prevent falls. This study quantified mediolateral margins of stability (MOS) and MOS sub-components in young individuals with traumatic unilateral transtibial amputation (TTA) and young able-bodied individuals (AB). Thirteen AB and nine TTA completed five 3-min walking trials in a Computer Assisted Rehabilitation ENvironment (CAREN) system under each of three test conditions: no perturbations, pseudo-random mediolateral translations of the platform, and pseudo-random mediolateral translations of the visual field. Compared to the unperturbed trials, TTA exhibited increased mean MOS and MOS variability during platform and visual field perturbations (p < 0.010). AB exhibited increased mean MOS during visual field perturbations and increased MOS variability during both platform and visual field perturbations (p < 0.050). During platform perturbations, TTA exhibited significantly greater values than AB for mean MOS (p < 0.050) and MOS variability (p < 0.050); variability of the lateral distance between the center of mass (COM) and base of support at initial contact (p < 0.005); mean and variability of the range of COM motion (p < 0.010); and variability of COM peak velocity (p < 0.050). As determined by mean MOS and MOS variability, young and otherwise healthy individuals with transtibial amputation achieved lateral stability similar to that of their able-bodied counterparts during unperturbed and visually-perturbed walking. However, based on mean and variability of MOS, unilateral transtibial amputation was shown to have affected lateral walking stability during platform perturbations. Published by Elsevier Ltd.