Kinetics of transfemoral amputees with osseointegrated fixation performing common activities of daily living
Kinetics of transfemoral amputees with osseointegrated fixation performing common activities of daily living
复制标题
DOI：
10.1016/j.clinbiomech.2007.02.005
复制
发表时间：
2007-07-01
影响因子：
1.8
通讯作者：
Pearcy, Mark J.
中科院分区：
文献类型：
--
作者：
Lee, Winson C. C.;Frossard, Laurent A.;Pearcy, Mark J.
背景通过植入固定（骨整合）将下肢假体直接锚定到骨上已被认为是使用传统承窝型假体后出现并发症的截肢者的一种极好的替代方法。然而，需要尝试优化固定的机械设计并完善康复计划。了解施加在固定上的载荷是实现这一目标的关键一步。使用载荷传感器测量了9例经股截肢患者在进行直线水平行走、上下楼梯和坡道以及绕圈行走等活动时施加在骨结合固定上的载荷。力和力矩模式沿着每个步态周期，幅度和时间发生的局部极值的负载，以及脉冲进行了分析。与直线水平行走相比，管理坡道和楼梯以及绕圈行走并没有产生显著的负荷增加（P > 0.05）。6种活动对膝关节内外轴的力矩模式不同，可能反映了不同的控制策略。本研究增加了对骨锚式骨结合假体生物力学的理解。所提供的载荷数据将有助于设计骨结合固定，以增加疲劳寿命并完善康复方案。(c)2007爱思唯尔有限公司保留所有权利。
Background. Direct anchorage of a lower-limb prosthesis to the bone through an implanted fixation (osseointegration) has been suggested as an excellent alternative for amputees experiencing complications from use of a conventional socket-type prosthesis. However, an attempt needs to be made to optimize the mechanical design of the fixation and refine the rehabilitation program. Understanding the load applied on the fixation is a crucial step towards this goal.Methods. The load applied on the osseointegrated fixation of nine transfemoral amputees was measured using a load transducer, when the amputees performed activities which included straight-line level walking, ascending and descending stairs and a ramp as well as walking around a circle. Force and moment patterns along each gait cycle, magnitudes and time of occurrence of the local extrema of the load, as well as impulses were analysed.Findings. Managing a ramp and stairs, and walking around a circle did not produce a significant increase (P > 0.05) in load compared to straight-line level walking. The patterns of the moment about the medio-lateral axis were different among the six activities which may reflect the different strategies used in controlling the prosthetic knee joint.Interpretations. This study increases the understanding of biomechanics of bone-anchored osseointegrated prostheses. The loading data provided will be useful in designing the osseointegrated fixation to increase the fatigue life and to refine the rehabilitation protocol. (c) 2007 Elsevier Ltd. All rights reserved.