Experimental characterization of the moment-angle curve during level and slope locomotion of transtibial amputee: Which parameters can be extracted to quantify the adaptations of microprocessor prosthetic ankle?
Experimental characterization of the moment-angle curve during level and slope locomotion of transtibial amputee: Which parameters can be extracted to quantify the adaptations of microprocessor prosthetic ankle?
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DOI：
10.1177/09544119211006523
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发表时间：
2021-03-30
期刊：
影响因子：
1.8
通讯作者：
Pillet, Helene
中科院分区：
文献类型：
--
作者：
Davot, Julie;Thomas-Pohl, Marie;Pillet, Helene
在经胫骨截肢的情况下，下肢损失造成的缺陷可以通过假肢足和适应性康复部分补偿。为了模拟踝关节对不同地形的适应性，新型假肢脚已经被开发出来。其中，微处理器假肢脚踝（MPA）有一个微处理器来控制电动或液压执行器，以适应脚踝在楼梯和斜坡上的运动。目的是研究从矩角曲线（MAC）中提取的参数，并使用它们比较水平和斜坡运动期间的3 MPA与能量储存和返回（ESR）脚。5例下肢经胫部截肢患者，与ESR足相比，连续施加3 MPA (proprioffoot (TM), Elan （TM), Meridium (TM)）。参与者在获取数据前有2周的适应期，然后是3周的洗脱期。由于脚踝处的MAC，在水平地面和12%坡度（向上和向下）上计算运动范围、平衡点、迟滞、后期姿态能量释放和准刚度。研究表明了MAC参数对MPA性能评价的相关性。特别是，与ESR相比，本研究中所有MPA测试都表明，行走条件之间的角度适应性更好，但推进的可用能量有所减少。在MPA中，主要结果是：(i)对于本体足（TM）：踝关节角度的适应，而不改变MAC的模式；（ii）对于Elan (TM)：运动范围的有限适应，但释放的能量有所改变；（iii）对于子午线（TM），运动范围的最高适应，但可用的推进能量最低。该研究的主要发现之一是展示和量化在不同行走条件下使用不同假肢脚时的运动范围和可用能量之间的关系。
In case of transtibial amputation, the deficit resulting from the loss of the lower limb can be partly compensated with a prosthetic foot and adapted rehabilitation. New prosthetic feet have been developed for transtibial amputees to mimic ankle adaptability to varying terrain. Among them, Microprocessor Prosthetic Ankles (MPA) have a microprocessor to control an electric or a hydraulic actuator to adapt ankle kinematics in stairs and slopes. The objective is to investigate parameters extracted from the moment-angle curve (MAC) and use them to compare 3 MPA during level and slope locomotion against energy storing and return (ESR) foot. Five persons with lower limb transtibial amputation successively fitted with 3 MPA (Propriofoot (TM), Elan (TM), Meridium (TM)) compared to their ESR foot. The participants had 2 weeks of adaptation before data acquisition and then a 3 week wash-out period. Range of motion, equilibrium point, hysteresis, late stance energy released, and quasi-stiffness were computed on level ground and 12% slope (upward and downward) thanks to the MAC at the ankle. The study shows the relevance of MAC parameters to evaluate the behavior of MPA. In particular, compared to ESR, all MPA tested in the present study demonstrated a better angle adaptation between walking conditions but a decrease of available energy for the propulsion. Among MPA, main results were: (i) for the Propriofoot (TM): an adaptation of the ankle angle without modification of the pattern of the MAC (ii) for the Elan (TM): a limited adaptation of the range of motion but a modification of the energy released (iii) for the Meridium (TM), the highest adaptation of the range of motion but the lowest available energy of propulsion. One of the main findings of the research is to show and quantify the relationship between range of motion and energy available when using different prosthetic feet in different walking conditions.