ANKLE, KNEE, AND HIP MOMENTS DURING STANDING WITH AND WITHOUT JOINT CONTRACTURES Simulation Study for Functional Electrical Stimulation
ANKLE, KNEE, AND HIP MOMENTS DURING STANDING WITH AND WITHOUT JOINT CONTRACTURES Simulation Study for Functional Electrical Stimulation
复制标题
站立时有或没有关节挛缩时的踝关节、膝关节和髋关节力矩 功能性电刺激的模拟研究
DOI：
--
复制
发表时间：
1998
影响因子：
3
通讯作者：
E. Marsolais
中科院分区：
文献类型：
--
作者：
H. Kagaya;Mukut Sharma;R. Kobetic;E. Marsolais
关节挛缩是截瘫患者站立时使用功能性电刺激的禁忌症之一。采用人体三节段连接力学模型进行仿真研究，计算有和无关节挛缩时站立时脚踝、膝盖和臀部的肌肉力矩。膝关节和髋关节角度以5°为增量变化，而踝关节角度以1°为增量变化。假设能量有效的姿势是踝关节、膝关节和髋关节的肌肉力矩的平方和最小。踝关节背屈5°，膝关节背屈0°，髋部背屈15°是无关节挛缩的最有效姿势。肌矩随挛缩角度的增大而增大。关节在足底屈曲6°踝关节、膝关节屈曲20°和/或髋关节屈曲20°处挛缩，产生潜在的不稳定姿势。这些发现表明，在使用功能性电刺激站立的截瘫患者中，一定程度的关节挛缩是可以容忍的。
Joint contractures have been one of the contraindications for use of functional electrical stimulation for standing in paraplegic patients. A simulation study using a three-segment link mechanical model of the human body was performed to calculate the muscle moments at the ankles, knees, and hips during standing with and without having joint contractures. The knee and hip angles were varied in 5° increments, whereas the ankle angles were varied in 1° increments. It was assumed that energy efficient posture was obtained with the least sum of the squared moments of the ankles, knees, and hips joints by the muscles. Ankles at 5° of dorsiflexion, knees at 0°, and hips at 15° of extension resulted in the most energy efficient posture without joint contractures. The muscle moments increased with the increase in angle of contractures. The joint contractures at ankle angles 6° of plantar flexion, knee angles 20° of flexion, and/or hip angles 20° of flexion produce a potentially unstable posture. These findings suggest that some degree of joint contractures can be tolerated in paraplegic patients using functional electrical stimulation for standing.