Influence of Ankle Motion on Bilateral Amputee Gait

我们建议研究假肢踝关节运动对双下肢截肢者步态力学的影响。双侧下肢截肢者通常双腿僵硬或僵硬，这可能部分是由于假肢踝关节的顺应性和运动范围不足。 他们可能会试图克服假肢的缺陷与补偿行动，增加他们的能量消耗在步态。 大多数关于截肢者步态的文献都与单侧截肢者有关，但很难根据单侧截肢者步态的数据确定需要显著改善的领域。 与单侧截肢者相比，双侧截肢者更需要改善假肢部件，因为他们行走时的能量需求增加，而且行走速度较慢。双侧截肢者步态期间的假体性能更容易评估，因为他们在行走时可供选择的生理控制选项较少。 文献中很少有关于其康复的结果研究报道，迄今为止还没有发表关于双腿截肢者的定量步态研究。我们将在VA芝加哥运动分析研究实验室对30名双侧经胫骨（膝盖以下）和经股骨（膝盖以上）截肢者进行定量步态分析，这些截肢者使用和不使用增加踝关节运动的假肢组件行走。这些组件包括Endolite Multiflex踝关节，用于增加踝关节背屈/跖屈和内翻/外翻，以及Otto Bock踝关节扭转适配器，用于增加横向平面旋转。 我们假设增加踝关节的运动将显著改善双侧下肢截肢者的步态。我们还将为15名健全人配备可最大限度地减少膝盖和脚踝运动的矫形器，研究模拟双侧截肢者步态。 我们假设，身体健全的人与限制踝关节和膝关节行走将有步态特征相似的双侧截肢者。 健全的步行模式作为一个有用的基础比较不同类型的病理步态，我们相信，改变运动系统的健全的人可以产生有价值的信息病理步态的机制。 这项研究的结果将有助于确定当前假肢技术的局限性，这些局限性抑制了截肢者的正常行走模式。

We propose to investigate the effect of prosthetic ankle motion on the mechanics of bilateral lower-limb amputee gait. Bilateral lower-limb amputees often walk with rigid or stiff legs, which may be due in part to insufficient compliance and ranges of motion in their prosthetic ankles. They may attempt to overcome prosthetic deficiencies with compensatory actions that increase their energy expenditure during gait. Most of the literature pertaining to amputee gait is concerned with persons having unilateral amputations, but it is difficult to identify areas where significant improvement is needed based upon data from unilateral amputee gait. Compared with unilateral amputees, persons with bilateral leg amputations have a greater need for improvement in prosthetic componentry because of their increased energy demand as they walk and their low speed of walking. Prosthetic performance during gait is easier to evaluate in bilateral amputees because they have fewer physiological control options available to them while they ambulate. Few outcome studies have been reported in the literature regarding their rehabilitation, and there have been no published quantitative gait studies on bilateral leg amputees to date. We will perform quantitative gait analyses in the VA Chicago Motion Analysis Research Laboratory on 30 bilateral transtibial (below-knee) and transfemoral (above-knee) amputees walking with and without prosthetic components that increase ankle motion. These components include the Endolite Multiflex Ankle to increase ankle dorsiflexion/plantarflexion and inversion/eversion, and the Otto Bock Ankle Torsion Adapter to increase transverse plane rotation. We hypothesize that increased ankle motion will significantly improve the gaits of bilateral lower-limb amputees. We will also study simulated bilateral amputee gait in 15 able- bodied persons by fitting them with orthoses that minimize knee and ankle motion. We hypothesize that able-bodied persons walking with constrained ankles and knees will have gait characteristics similar to bilateral amputees. The able-bodied walking pattern serves as a useful basis of comparison for different types of pathological gait, and we believe that altering the locomotor system of the able-bodied person can yield valuable information concerning the mechanisms of pathological gait. The results from this study will aid in identifying limitations in current prosthetic technology that inhibit normal patterns of walking in amputees.