Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device
Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device
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DOI：
10.1186/s12984-018-0347-1
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发表时间：
2018-01-27
影响因子：
5.1
通讯作者：
Takahashi, Kota Z.
中科院分区：
文献类型：
--
作者：
Ray, Samuel F.;Wurdeman, Shane R.;Takahashi, Kota Z.
背景资料：有许多研究调查了假脚之间的生物力学差异，但没有随着时间的推移而适应的变化。有必要客观的措施来量化的过程中的适应与经胫骨截肢的个人。机械功率和功分布是现代能量储存和返回型假体的主要焦点，其努力增加来自假体的能量返回。假体存储和返回的能量的量（即，在站立期间的负功和正功）直接受到用户的负荷策略的影响，该负荷策略可能对适应期过程中的改变敏感。本研究的目的是检查下肢机械工作配置文件的变化，在步行三个星期的适应一个新的prosthes.Methods：一个回顾性分析进行了22个人与单侧经胫骨截肢。每个人都在他们目前的活动水平（K3或以上）下获得了一个新的假肢，并戴了三周。运动学和动力学的措施，记录从地上行走在0，1.5，和3周进入适应期，在一个自我选择的步伐。使用统一的可变形段模型和六度自由度模型的膝盖和hipe.Results：积极的工作，从假体踝足增加了6.1%，健全的踝足3周后5.7%（p = 0.041，0.036）的积极和消极的工作所做的假体和健全的踝足计算。假体或健全踝足的负功无显著变化（p = 0.115，0.192）。3周后，自选步行速度也增加了4.1%（p = 0.038）。我们的数据显示出很大的受试者间差异，其中一些人在工作概况方面遵循群体趋势，而另一些人在结果变量方面则具有相反的趋势。结论：经过3周的适应后，22名经胫骨截肢者中的14名增加了能量从假肢中返回。这些发现可能表明，在适应期后，个人可以更好地利用假体的弹簧功能。
Background: There are many studies that have investigated biomechanical differences among prosthetic feet, but not changes due to adaptation over time. There is a need for objective measures to quantify the process of adaptation for individuals with a transtibial amputation. Mechanical power and work profiles are a primary focus for modern energy-storage-and-return type prostheses, which strive to increase energy return from the prosthesis. The amount of energy a prosthesis stores and returns (i.e., negative and positive work) during stance is directly influenced by the user's loading strategy, which may be sensitive to alterations during the course of an adaptation period. The purpose of this study was to examine changes in lower limb mechanical work profiles during walking following a three-week adaptation to a new prosthesis.Methods: A retrospective analysis was performed on 22 individuals with a unilateral transtibial amputation. Individuals were given a new prosthesis at their current mobility level (K3 or above) and wore it for three weeks. Kinematic and kinetic measures were recorded from overground walking at 0, 1.5, and 3 weeks into the adaptation period at a self-selected pace. Positive and negative work done by the prosthesis and sound ankle-foot were calculated using a unified deformable segment model and a six-degrees-of-freedom model for the knee and hip.Results: Positive work from the prosthesis ankle-foot increased by 6.1% and sound ankle-foot by 5.7% after 3 weeks (p = 0.041, 0.036). No significant changes were seen in negative work from prosthesis or sound ankle-foot (p = 0.115, 0.192). There was also a 4.1% increase in self-selected walking speed after 3 weeks (p = 0.038). Our data exhibited large inter-subject variations, in which some individuals followed group trends in work profiles while others had opposite trends in outcome variables.Conclusions: After a 3-week adaptation, 14 out of 22 individuals with a transtibial amputation increased energy return from the prosthesis. Such findings could indicate that individuals may better utilize the spring-like function of the prosthesis after an adaptation period.