Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket
Effect of prosthetic gel liner thickness on gait biomechanics and pressure distribution within the transtibial socket
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DOI：
10.1682/jrrd.2010.06.0121
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发表时间：
2012-01-01
影响因子：
--
通讯作者：
Gard, Steven
中科院分区：
文献类型：
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作者：
Boutwell, Erin;Stine, Rebecca;Gard, Steven
假肢凝胶衬垫通常用于下肢截肢者，以使假肢接受腔更舒适。然而，它们对残肢压力和步态特征的影响还没有得到彻底的探讨。本研究调查了凝胶内衬厚度对单侧经胫骨截肢患者的峰值插座压力和步态模式的影响。当受试者在两种不同均匀厚度的衬垫上行走时，获得压力和定量步态数据。使用较厚内衬时，腓骨头峰值压力平均降低（p = 0.04）26 +/-21%，而垂直地面反作用力（GRF）载荷峰值增加3 +/- 3%（p = 0.02）。大多数受试者感觉到较厚内衬的假肢接受腔内的舒适度增加，这可能与腓骨头峰值压力降低有关。此外，虽然较厚的内衬可能通过提供更具顺应性的肢体-关节窝界面来增加舒适度，但更高的顺应性可能会减少对残肢的力和振动反馈，并导致更大的垂直GRF载荷峰值。我们得出结论，确定特定个体的最佳凝胶衬垫厚度将需要进一步调查，以更好地识别和理解用户感知、残肢压力分布和步态生物力学之间发生的妥协。
Prosthetic gel liners are often prescribed for persons with lower-limb amputations to make the prosthetic socket more comfortable. However, their effects on residual limb pressures and gait characteristics have not been thoroughly explored. This study investigated the effects of gel liner thickness on peak socket pressures and gait patterns of persons with unilateral transtibial amputations. Pressure and quantitative gait data were acquired while subjects walked on liners of two different uniform thicknesses. Fibular head peak pressures were reduced (p = 0.04) with the thicker liner by an average of 26 +/- 21%, while the vertical ground reaction force (GRF) loading peak increased 3 +/- 3% (p = 0.02). Most subjects perceived increased comfort within the prosthetic socket with the thicker liner, which may be associated with the reduced fibular head peak pressures. Additionally, while the thicker liner presumably increased comfort by providing a more compliant limb-socket interface, the higher compliance may have reduced force and vibration feedback to the residual limb and contributed to the larger vertical GRF loading peaks. We conclude that determining optimal gel liner thickness for a particular individual will require further investigations to better identify and understand the compromises that occur between user perception, residual-limb pressure distribution, and gait biomechanics.