Whole-body angular momentum during sloped walking using passive and powered lower-limb prostheses
Whole-body angular momentum during sloped walking using passive and powered lower-limb prostheses
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DOI：
10.1016/j.jbiomech.2016.09.010
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发表时间：
2016-10-03
影响因子：
2.4
通讯作者：
Silverman, Anne K.
中科院分区：
文献类型：
--
作者：
Pickle, Nathaniel T.;Wilken, Jason M.;Silverman, Anne K.
斜坡行走需要改变策略，以保持相对于平地行走的动态平衡，如身体健全的个体的矢状面全身角动量（H）的变化所证明的。踝跖屈肌对调节H是至关重要的，经胫骨截肢导致这些肌肉功能丧失会影响这种调节。然而，目前还不清楚，如果一个动力假体，更接近模拟完整的踝关节功能比被动储能和返回假体，影响H不同的斜坡行走。因此，我们的目的是调查在使用动力和被动假体时，单侧经胫骨截肢的个人H。总体而言，H的范围是更大的人与经胫骨截肢相对于健全的个人。在10下降，截肢的人没有减少H健全的人一样多，并减少了假肢制动地面反作用力和膝关节功率吸收。在+10度斜坡上，截肢者的H相对增加比健全者大，假肢脚的位置更靠前，髋关节发电峰值更高。动力假肢条件导致在一个较小的范围内的H假肢的立场相对于被动的条件，虽然它仍然大于健全的个人。我们的研究结果表明，假肢踝关节发电可能有助于调节动态平衡假肢的立场，但单独是不足以恢复H健全的个人在斜坡上。膝伸肌和双关节腓肠肌在斜坡上调节H的作用有待进一步研究。(C)2016爱思唯尔有限公司版权所有
Sloped walking requires altered strategies for maintaining dynamic balance relative to level-ground walking, as evidenced by changes in sagittal-plane whole-body angular momentum (H) in able-bodied individuals. The ankle plantarflexor muscles are critical for regulating H, and functional loss of these muscles from transtibial amputation affects this regulation. However, it is unclear if a powered prosthesis, which more closely emulates intact ankle function than a passive energy-storage-and-return prosthesis, affects H differently during sloped walking. Therefore, our purpose was to investigate H in individuals with unilateral transtibial amputation when using powered and passive prostheses. Overall, the range of H was greater in people with a transtibial amputation relative to able-bodied individuals. On a 10 decline, individuals with amputation did not decrease H as much as able-bodied individuals, and had reduced prosthetic limb braking ground reaction forces and knee power absorption. On a +10 degrees incline, individuals with amputation had a greater relative increase of H than able-bodied individuals, a more anterior placement of the prosthetic foot, and higher peak hip power generation. The powered prosthesis condition resulted in a smaller range of H during prosthetic stance relative to the passive condition, although it was still larger than able-bodied individuals. Our results suggest that prosthetic ankle power generation may help regulate dynamic balance during prosthetic stance, but alone is not sufficient for restoring H to that of able-bodied individuals on slopes. Contributions of knee extensor muscles and the biarticular gastrocnemius in regulating H on slopes should be further investigated. (C) 2016 Elsevier Ltd. All rights reserved.