Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity
Mechanical work performed by individual limbs of transfemoral amputees during step-to-step transitions: Effect of walking velocity
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DOI：
10.1177/0954411913514036
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发表时间：
2014-01-01
期刊：
影响因子：
1.8
通讯作者：
Pillet, Helene
中科院分区：
文献类型：
--
作者：
Bonnet, Xavier;Villa, Coralie;Pillet, Helene
经股截肢患者在步态过程中较大的代谢需求限制了他们的自主性和行走速度。通过步态分析量化的经股截肢者的运动学和运动学模式的重大改变可能解释了他们更高的能量成本。Donelan等人。提出了一种研究步态生物力学与代谢成本关系的方法--个体肢法。在这项研究中，我们应用这种方法来量化受影响的和完整的经股截肢患者的肢体所做的机械功。我们比较了六名活跃的单侧经股截肢患者和六名无症状受试者的对照组。与对照组相比，我们发现，在逐步过渡的过程中，患肢产生的机械功明显减少，而非患肢产生的功明显增加。我们还发现，这种机械功随着行走速度的增加而增加；对于患病的腿来说，增加的幅度不是很明显，而对于未患病的腿来说，增加的幅度很大。最后，我们观察到，受影响的腿产生的较少的功与站立后期髋关节屈曲力矩的增加有关，这是受影响腿开始膝关节屈曲所必需的。使用单肢方法和传统的步态实验室设备，可以量化接受经股截肢的人在步态过程中所做的机械功。该方法提供了对假体装配和康复有用的信息。
The greater metabolic demand during the gait of people with a transfemoral amputation limits their autonomy and walking velocity. Major modifications of the kinematic and kinetic patterns of transfemoral amputee gait quantified using gait analysis may explain their greater energy cost. Donelan et al. proposed a method called the individual limb method to explore the relationships between the gait biomechanics and metabolic cost. In the present study, we applied this method to quantify mechanical work performed by the affected and intact limbs of transfemoral amputees. We compared a cohort of six active unilateral transfemoral amputees to a control group of six asymptomatic subjects. Compared to the control group, we found that there was significantly less mechanical work produced by the affected leg and significantly more work performed by the unaffected leg during the step-to-step transition. We also found that this mechanical work increased with walking velocity; the increase was less pronounced for the affected leg and substantial for the unaffected leg. Finally, we observed that the lesser work produced by the affected leg was linked to the increase in the hip flexion moment during the late stance phase, which is necessary for initiating knee flexion in the affected leg. It is possible to quantify the mechanical work performed during gait by people with a transfemoral amputation, using the individual limb method and conventional gait laboratory equipment. The method provides information that is useful for prosthetic fitting and rehabilitation.