Mechanical energetic contributions from individual muscles and elastic prosthetic feet during symmetric unilateral transtibial amputee walking: A theoretical study
Mechanical energetic contributions from individual muscles and elastic prosthetic feet during symmetric unilateral transtibial amputee walking: A theoretical study
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DOI：
10.1016/j.jbiomech.2006.07.009
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发表时间：
2007-01-01
影响因子：
2.4
通讯作者：
Sasaki, Kotaro
中科院分区：
文献类型：
--
作者：
Zmitrewicz, Robert J.;Neptune, Richard R.;Sasaki, Kotaro
能量存储与返回（ESAR）足踝假肢的开发是为了改善下肢截肢者的步态表现。然而，人们对它们在提供通常由脚踝肌肉提供的身体部分机械能量方面的有效性知之甚少。这项理论研究的目的是使用肌肉驱动的向前动力学模拟单侧经胫骨截肢者和非截肢者行走，以确定 ESAR 假肢对躯干支撑、向前推进和腿部摆动起始的贡献，以及个体肌肉必须如何补偿才能产生正常、对称的步态模式。模拟分析显示，ESAR 假肢提供了必要的躯干支撑，但它无法提供通常由跖屈肌提供的净躯干向前推进力和通常由双关节腓肠肌提供的腿部摆动启动。为了补偿，残余的腿臀大肌和股直肌分别向躯干提供了更多的能量，以便在早期姿势和晚期姿势进入挥杆前向前推进，而残余的髂腰肌在挥杆前和早期向腿部提供了更多的能量，以帮助启动挥杆。在完整的腿中，比目鱼肌、臀大肌和股直肌在站立的前半段向躯干传递了更多的能量以向前推进，而髂腰肌则增加了在摆动前和摆动初期传递的腿部能量。因此，ESAR 假体存储和释放的能量与这些肌肉补偿相结合能够产生正常、对称的步态模式，尽管各种神经肌肉和肌肉骨骼约束可能使这种模式不是最佳的。 (C) 2006 Elsevier Ltd. 保留所有权利。
Energy storage and return (ESAR) foot-ankle prostheses have been developed in an effort to improve gait performance in lower-limb amputees. However, little is known about their effectiveness in providing the body segment mechanical energetics normally provided by the ankle muscles. The objective of this theoretical study was to use muscle-actuated forward dynamics simulations of unilateral transtibial amputee and non-amputee walking to identify the contributions of ESAR prostheses to trunk support, forward propulsion and leg swing initiation and how individual muscles must compensate in order to produce a normal, symmetric gait pattern. The simulation analysis revealed the ESAR prosthesis provided the necessary trunk support, but it could not provide the net trunk forward propulsion normally provided by the plantar flexors and leg swing initiation normally provided by the biarticular gastrocnemius. To compensate, the residual leg gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in early stance and late stance into pre-swing, respectively, while the residual iliopsoas delivered increased energy to the leg in pre- and early swing to help initiate swing. In the intact leg, the soleus, gluteus maximus and rectus femoris delivered increased energy to the trunk for forward propulsion in the first half of stance, while the iliopsoas increased the leg energy it delivered in pre- and early swing. Thus, the energy stored and released by the ESAR prosthesis combined with these muscle compensations was able to produce a normal, symmetric gait pattern, although various neuromuscular and musculoskeletal constraints may make such a pattern non-optimal. (C) 2006 Elsevier Ltd. All rights reserved.