Magnitude and variability of loading on the osseointegrated implant of transfemoral amputees during walking
Magnitude and variability of loading on the osseointegrated implant of transfemoral amputees during walking
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DOI：
10.1016/j.medengphy.2007.09.003
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发表时间：
2008-09-01
影响因子：
2.2
通讯作者：
Branemark, Rickard
中科院分区：
文献类型：
--
作者：
Lee, Winson C. C.;Frossard, Laurent A.;Branemark, Rickard
本研究直接测量了经股截肢者在水平行走时作用于骨结合种植体系统基台上的载荷，并研究了截肢者体内和截肢者之间载荷的变异性。12名活跃的经股截肢者（年龄：54 - 12岁，体重：84.3 +/- 16.3 kg，身高：17.8 +/- 0.10 m），安装了一个骨整合植入物超过1年，参加了这项研究。使用安装在基台和假肢膝关节之间的商用六通道传感器，在无阻碍的水平直线行走过程中测量施加在基台上的载荷。三维力和力矩的模式和大小被揭示出来。结果显示，每个受试者的步长变异性较低，但体重归一化力和力矩以及脉冲数据的局部极值的受试者间变异性较高。受试者之间的高度变异性表明，植入物系统的机械设计应针对每个个体进行定制，或者适合所有人的设计应考虑广泛截肢者的最高载荷值。提示在康复训练中，应根据不同的受试者采用不同的负荷训练方法.因此，所证明的载荷大小和可变性在设计能够更好地抵抗机械失效的骨结合种植体系统和改进康复方案中应该是有用的。(C)2007年妇女平等问题国际研究所。由爱思唯尔有限公司出版。保留所有权利。
This study directly measured the load acting on the abutment of the osseointegrated implant system of transfemoral amputees during level walking, and studied the variability of the load within and among amputees. Twelve active transfemoral amputees (age: 54 12 years, mass: 84.3 +/- 16.3 kg, height: 17.8 +/- 0.10 m) fitted with an osseointegrated implant for over I year participated in the study. The load applied on the abutment was measured during unimpeded, level walking in a straight line using a commercial six-channel transducer mounted between the abutment and the prosthetic knee. The pattern and the magnitude of the three-dimensional forces and moments were revealed. Results showed a low step-to-step variability of each subject, but a high subject-to-subject variability in local extrema of body-weight normalized forces and moments and impulse data. The high subject-to-subject variability suggests that the mechanical design of the implant system should be customized for each individual, or that a fit-all design should take into consideration the highest values of load within a broad range of amputees. It also suggests specific loading regime in rehabilitation training are necessary for a given subject. Thus the loading magnitude and variability demonstrated should be useful in designing an osseointegrated implant system better able to resist mechanical failure and in refining the rehabilitation protocol. (C) 2007 IPEM. Published by Elsevier Ltd. All rights reserved.