Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees
Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees
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DOI：
10.1016/s0268-0033(00)00026-7
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发表时间：
2000-11-01
影响因子：
1.8
通讯作者：
Clinton, C
中科院分区：
文献类型：
--
作者：
Sanders, JE;Zachariah, SG;Clinton, C
目标。目的：评价节律、假体部件和时间的改变对经胫骨截肢者的界面压力和所产生的剪应力的影响。使用定制设计的仪器监测3例单侧经胫骨截肢患者的13个部位的界面应力。先前的研究表明，每周一次的残肢改变对界面应力的影响比假体对齐的改变更大。以前还没有研究步调或成分的变化对界面应力分布的影响，也没有将它们的影响与每周的变化进行比较。在四个疗程的三个步调中，分别测试了五种不同的假体结构。分析了峰值压力和合成剪应力的大小和时间，以及相应的合成剪切角。对于所有受试者，三种韵律或五种成分构型都没有显著地(P<；0.05)引起较高或较低的界面应力。然而，与AirStance(气动支架)/西雅图轻足单元相比，铝塔/SACH脚部组合导致了较晚的峰值界面应力计时(占站位阶段的百分比)。每周训练之间的界面应力变化比不同节律之间或不同成分构型之间的界面应力变化更高和更频繁。截肢者对每周一周的残肢变化的补偿能力低于对截肢内节律或成分改变的补偿能力。(C)2000爱思唯尔科学有限公司。保留所有权利。
Objective. To evaluate the effects of changes in cadence, prosthetic componentry, and time on interface pressures and resultant shear stresses in trans-tibial amputee case studies.Design. Interface stresses were monitored using custom-designed instrumentation at 13 sites on three subjects with unilateral trans-tibial amputation walking with patellar-tendon-bearing prosthetic limbs.Background. Previous studies suggested that week-to-week residual limb changes altered interface stresses more than did alterations in prosthetic alignment. No studies investigating effects of changes in cadence or componentry on interface stress distributions nor comparing their influence with week-to-week changes have been conducted previously.Methods. Five different prosthetic componentry configurations were tested at each of three cadences in four sessions. Data were analysed for the magnitudes and timings of peak pressures and resultant shear stresses as well as corresponding resultant shear angles.Results. None of the three cadences or five componentry configurations consistently induced significantly (P < 0.05) higher or lower interface stress magnitudes for all subjects. However, an Aluminium Pylon/SACH Foot combination compared with an AirStance (pneumatic shank)/Seattle LightFoot unit induced later peak interface stress timings as a percentage of stance phase. Higher and more frequent interface stress changes were seen between the weekly sessions than between different cadences or between different componentry configurations.Conclusion. The amputees' capabilities to compensate for week-to-week residual limb changes were less than these for intrasession cadence or componentry alterations. (C) 2000 Elsevier Science Ltd. All rights reserved.