The influence of energy storage and return foot stiffness on walking mechanics and muscle activity in below-knee amputees
The influence of energy storage and return foot stiffness on walking mechanics and muscle activity in below-knee amputees
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DOI：
10.1016/j.clinbiomech.2011.06.007
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发表时间：
2011-12-01
影响因子：
1.8
通讯作者：
Neptune, Richard R.
中科院分区：
文献类型：
--
作者：
Fey, Nicholas P.;Klute, Glenn K.;Neptune, Richard R.
背景：膝下截肢者通常会经历不对称的步态模式，并在其完整和残留的腿中发展出共病。碳纤维假脚已经被开发来通过利用弹性能量存储和返回来提供身体支撑、向前推进和腿部摆动启动来最小化这些不对称性。然而，假肢脚刚度如何影响步行特性还没有得到很好的理解。本研究的目的是确定足部僵硬的运动学，动力学，肌肉活动，假肢的能量储存和返回，并在截肢者walking. Methods机械效率的影响：进行了全面的生物力学分析12个单侧膝下截肢。受试者走在地上在1.2米/秒的三个假肢脚不同的龙骨和脚跟刚度水平，这是使用增材制造。调查结果：随着刚度下降，峰值残余和完整的腿踝关节角度和残余腿膝关节屈曲角度增加。残腿和完整腿制动地面反作用力和膝伸肌力矩、残腿股肌和臀中肌活动以及完整腿股肌和股直肌活动也增加。残腿第二垂直地面反力峰值和腘绳肌活动度降低，完整腿第一垂直地面反力峰值降低。此外，假肢的能量储存和返回增加和机械效率下降，因为stiffened.Interpretation：脚刚度降低可以增加假肢的运动范围，中期站姿能量储存和后期站姿能量返回，但净贡献向前推进和摆动启动可能是有限的，因为额外的肌肉活动，以提供身体的支持变得必要。(C)2011爱思唯尔有限公司版权所有。
Background: Below-knee amputees commonly experience asymmetrical gait patterns and develop comorbidities in their intact and residual legs. Carbon fiber prosthetic feet have been developed to minimize these asymmetries by utilizing elastic energy storage and return to provide body support, forward propulsion and leg swing initiation. However, how prosthetic foot stiffness influences walking characteristics is not well-understood. The purpose of this study was to identify the influence of foot stiffness on kinematics, kinetics, muscle activity, prosthetic energy storage and return, and mechanical efficiency during amputee walking.Methods: A comprehensive biomechanical analysis was performed on 12 unilateral below-knee amputees. Subjects walked overground at 1.2 m/s with three prosthetic feet of varying keel and heel stiffness levels, which were created using additive manufacturing.Findings: As stiffness decreased, peak residual and intact leg ankle angles and residual leg knee flexion angle increased. The residual and intact leg braking ground reaction forces and knee extensor moments, residual leg vastus and gluteus medius activity, and intact leg vastus and rectus femoris activity also increased. The second vertical ground reaction force peak and hamstring activity in the residual leg and first vertical ground reaction force peak in the intact leg decreased. In addition, prosthetic energy storage and return increased and mechanical efficiency decreased as stiffness decreased.Interpretation: Decreasing foot stiffness can increase prosthesis range of motion, mid-stance energy storage and late-stance energy return, but the net contributions to forward propulsion and swing initiation may be limited as additional muscle activity to provide body support becomes necessary. (C) 2011 Elsevier Ltd. All rights reserved.