Can a powered knee-ankle prosthesis improve weight-bearing symmetry during stand-to-sit transitions in individuals with above-knee amputations?
Can a powered knee-ankle prosthesis improve weight-bearing symmetry during stand-to-sit transitions in individuals with above-knee amputations?
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DOI：
10.1186/s12984-023-01177-w
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发表时间：
2023-05-02
影响因子：
5.1
通讯作者：
Lenzi, Tommaso
中科院分区：
文献类型：
--
作者：
Hunt, Grace R.;Hood, Sarah;Gabert, Lukas;Lenzi, Tommaso
膝上截肢后，缺失的生物膝关节和踝关节被被动假体装置取代。被动假肢能够在“负能量”任务期间使用阻尼器系统耗散有限的能量，比如坐着。然而，被动假膝在屈膝时不能在坐姿运动结束时提供高水平的阻力，使用者需要最多的支撑。结果，使用者被迫用他们的上半身、剩余的臀部和完整的腿进行过度补偿，和/或以弹道和不受控制的运动坐下来。动力假体有可能解决这个问题。电动假肢关节由电机控制，与被动阻尼器系统相比，它可以在更大的关节位置范围内产生更高水平的阻力。因此，电动假体有可能使膝上截肢者坐着更容易控制，更容易，改善他们的功能活动能力。十名膝盖以上截肢的人坐下来，使用他们开出的被动假体和研究提供动力的膝关节-脚踝假体。受试者对每个假体进行三次坐姿，同时我们记录完整股四头肌的关节角度、力量和肌肉活动。我们的主要观察指标是完整股四头肌的负重对称性和肌肉力量。我们对这些结果指标进行配对t检验，以测试被动假体和动力型假体之间的显著差异。我们发现，与被动假体相比，受试者坐在电动假体上时，平均承重对称性提高了42.1%。这一差异是显著的(p = 0.0012)，当使用电动假体时，每个受试者的负重对称性都得到了改善。虽然完整的股四头肌收缩的形状不同，但信号的积分和峰值在不同条件下都没有显著差异(积分p >； 0.01，峰值p >； 0.01)。在这项研究中，我们发现，与被动假体相比，动力型膝关节-脚踝假体显著改善了坐姿时的负重对称性。然而，我们没有观察到完整肢体肌肉力量的相应减少。这些结果表明，电动假肢装置有可能改善膝关节以上截肢患者坐着时的平衡，并为未来电动假肢的发展提供了洞察力。
After above-knee amputation, the missing biological knee and ankle are replaced with passive prosthetic devices. Passive prostheses are able to dissipate limited amounts of energy using resistive damper systems during “negative energy” tasks like sit-down. However, passive prosthetic knees are not able to provide high levels of resistance at the end of the sit-down movement when the knee is flexed, and users need the most support. Consequently, users are forced to over-compensate with their upper body, residual hip, and intact leg, and/or sit down with a ballistic and uncontrolled movement. Powered prostheses have the potential to solve this problem. Powered prosthetic joints are controlled by motors, which can produce higher levels of resistance at a larger range of joint positions than passive damper systems. Therefore, powered prostheses have the potential to make sitting down more controlled and less difficult for above-knee amputees, improving their functional mobility. Ten individuals with above-knee amputations sat down using their prescribed passive prosthesis and a research powered knee-ankle prosthesis. Subjects performed three sit-downs with each prosthesis while we recorded joint angles, forces, and muscle activity from the intact quadricep muscle. Our main outcome measures were weight-bearing symmetry and muscle effort of the intact quadricep muscle. We performed paired t-tests on these outcome measures to test for significant differences between passive and powered prostheses. We found that the average weight-bearing symmetry improved by 42.1% when subjects sat down with the powered prosthesis compared to their passive prostheses. This difference was significant (p = 0.0012), and every subject’s weight-bearing symmetry improved when using the powered prosthesis. Although the intact quadricep muscle contraction differed in shape, neither the integral nor the peak of the signal was significantly different between conditions (integral p > 0.01, peak p > 0.01). In this study, we found that a powered knee-ankle prosthesis significantly improved weight-bearing symmetry during sit-down compared to passive prostheses. However, we did not observe a corresponding decrease in intact-limb muscle effort. These results indicate that powered prosthetic devices have the potential to improve balance during sit-down for individuals with above-knee amputation and provide insight for future development of powered prosthetics.
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影响因子：
2.4
作者：
Ehrig, Rainald M.;Taylor, William R.;Heller, Markus O.
通讯作者：
Heller, Markus O.
DOI：
10.1109/iembs.2011.6091712
发表时间：
2011
期刊：
Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference
影响因子：
--
作者：
Gao F;Zhang F;Huang H
通讯作者：
Huang H
影响因子：
4.3
作者：
Gabert, Lukas;Lenzi, Ibininaso
通讯作者：
Lenzi, Ibininaso
影响因子：
3.2
作者：
Dall, Philippa M.;Kerr, Andrew
通讯作者：
Kerr, Andrew
影响因子：
5.7
作者：
Gabert L;Hood S;Tran M;Cempini M;Lenzi T
通讯作者：
Lenzi T