Compensatory mechanism involving the hip joint of the intact limb during gait in unilateral trans-tibial amputees
Compensatory mechanism involving the hip joint of the intact limb during gait in unilateral trans-tibial amputees
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DOI：
10.1016/j.jbiomech.2008.07.018
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发表时间：
2008-10-20
影响因子：
2.4
通讯作者：
Beyaert, C.
中科院分区：
文献类型：
--
作者：
Grumillier, C.;Martinet, N.;Beyaert, C.
在立场阶段开始，在单侧跨内侧截肢术（TTA）中，完整肢体中的髋部动力学进行了评估，以评估其对补偿功能的贡献。我们假设（1）H1功率阶段（步态周期的0-30％）的髋关节总工作增加，包括初始负相位，以及（2）髋关节工作的加剧，以响应假体错位引起的不舒服步态。在17个单方面TTA和15名健康受试者中以相同的自我选择的速度行走，以三个假体比对进行三维步态分析：初始比对（IA）； IA在内部旋转（IR）或6度外旋转时改变了6度。患者在IR条件下报告了步态的最佳舒适性，并且主要在IR条件下不适。在H1功率阶段，在完整的肢体中，髋关节的一致初始屈曲运动（步态周期为0-8％）与负面工作有关，然后是髋关节扩展和正常工作发生积极的工作（一个健康的个体除外）。与在IR条件下的对照四肢相比，完整和假肢的HIP工作的绝对值显着更高，并且仅在IR条件下仅在完整的肢体中显着增加，这表明后者具有补偿性功能。在完整的肢体中，除了膝关节外，早期的髋关节阴性工作有助于吸收能量，以补偿假肢肢体施加的较低能量吸收。 （c）2008 Elsevier Ltd.保留所有权利。
Hip dynamics in the intact limb during the beginning of stance phase in unilateral trans-tibial amputees (TTA) was studied to evaluate its contribution to compensatory function. We hypothesized (1) an increase in hip total work during H1 power phase (0-30% of gait cycle) including an initial negative phase and (2) an intensification of the hip work in response to uncomfortable gait induced by prosthesis misalignment. Three-dimensional gait analysis was conducted in 17 unilateral TTA and 15 healthy subjects walking at the same self-selected speed in three prosthetic alignments: initial alignment (IA); IA altered either by 6 degrees of internal rotation (IR) or by 6 degrees of external rotation. Patients reported best comfort of gait in IR condition and discomfort mainly in IR condition. During the H1 power phase, in intact limbs a consistent initial flexion movement of the hip (0-8% gait cycle) was associated to negative work and was followed by hip extension and positive work whereas in both prosthetic and control limbs only hip extension and positive work occurred (except in one healthy individual). Absolute value of hip work during H1 phase was significantly higher in intact and prosthetic limbs compared to control limbs in IR condition and was further significantly increased in IR condition only in intact limbs demonstrating a compensatory function of the latter. In intact limbs, early hip negative work contributed to energy absorption in addition to the knee joint probably to compensate the lower energy absorption exerted by the prosthetic limbs. (c) 2008 Elsevier Ltd. All rights reserved.