Effects of prosthetic foot forefoot flexibility on gait of unilateral transtibial prosthesis users
Effects of prosthetic foot forefoot flexibility on gait of unilateral transtibial prosthesis users
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DOI：
10.1682/jrrd.2009.10.0166
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发表时间：
2010-01-01
影响因子：
--
通讯作者：
Edwards, Mark
中科院分区：
文献类型：
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作者：
Klodd, Elizabeth;Hansen, Andrew;Edwards, Mark
本研究采用5只实心踝关节假肢，随机双盲交叉研究14例单侧胫骨假体使用者前足柔韧性对步态的影响。通过改变前足部屈曲铰链的数量来改变实验脚的柔韧性。当比较实验中的假足条件时，测量到的假肢踝关节背屈活动范围随着柔韧性的增加而增加3.3度(p<；0.001)，而脚的前力矩臂(以有效足长比衡量)增加了足长的23%而柔韧性降低(p<；0.001)。受试者还显示，随着柔韧性的降低，在行走的后期站立阶段，声音和假体踝关节力矩之间的差值增加到0.53Nm/kg(p<；0.001)。当受试者使用柔韧性最大的脚时，声音侧和假肢侧垂直地面反作用力的第一峰值之间的差值增加了体重的9%(p=0.001)。这项研究的结果表明，前足部分过于灵活的实心踝关节假肢设计在站立后期和假肢与对侧肢体之间的负荷过渡期间会产生“下降”效应。
Five solid-ankle experimental prosthetic feet were used in this double-blind randomized crossover study to determine the effects of forefoot flexibility on gait of 14 unilateral transtibial prosthesis users. Flexibility in experimental feet was altered by changing the number of flexural hinges in their forefoot sections. When experimental prosthetic foot conditions were compared, measured prosthetic ankle dorsiflexion range of motion increased as much as 3.3 degrees with increasing flexibility (p < 0.001) and the foot's anterior moment arm (measured as the effective foot length ratio) increased as much as 23% of the foot length with decreasing flexibility (p < 0.001). Subjects also showed increases in the difference between sound and prosthetic ankle moments as high as 0.53 Nm/kg in late stance phase of walking as flexibility decreased (p < 0.001). The difference between first peaks of the vertical ground reaction forces on the sound and prosthetic sides increased as much as 9% of body weight when subjects used the foot with the greatest flexibility (p = 0.001). The results of this study suggest solid-ankle prosthetic foot designs with overly flexible forefoot sections can cause a "drop-off' effect in late stance phase and during the transition of loading between prosthetic and contralateral limbs.