A New Biomechanical Model to Examine Joint Control Adaptations during Running in

描述（由申请人提供）：在美国，超过160万人患有肢体丧失，仅在这个国家每年就有80，000至90，000例下肢截肢手术。运动减轻了我们在家里、工作和社区中进行日常活动的能力，对于接受下肢截肢的人来说，必须达到运动水平，以最大限度地提高生活质量。早期对下肢截肢（ILEA）患者的“功能能力”的研究发现，最困难的体力活动是跑步。跑步专用假体（RSP）的最新发展吸引了许多ILEA选择跑步作为他们的心血管锻炼形式，并且很可能先前研究中报道的跑步的心血管益处延伸到这一人群。然而，正如我们的初步数据和以前的研究所表明的那样，使用RSP跑步的冲击力和机械适应性可能会使这一群体面临身体损伤和退行性关节疾病的风险。我们对ILEA运行的初步数据表明，记录的地面反作用力提供了不对称的负载与完整的肢体比残肢承担更大的负载的四肢。这种模式在不同的运行速度下是一致的。不对称肢体负荷已被认为是退行性关节疾病（DJD）发展和进展的一个风险因素，但需要更具体的数据，如关节动力学的适应，以更好地了解DJD和过度使用损伤的机制。不幸的是，数量非常有限的研究提供了更具体的机制，关节负荷和适应ILEA在运行过程中的见解。此外，目前还没有经过验证的生物力学模型，用于与RSP一起运行的ILEA的关节动力学分析。我们的初步工作已经开发出这样一个模型，并表明，准确的联合动力学测量可以估计和解释。使用这个模型，我们建议评估通过下肢的力传递和与RSP运行的ILEA的生物力学适应。通过系统地测试一系列的运行速度，我们将检查关节动力学适应，以实现这些速度比较和对比ILEA适应健全的控制对象。我们的中心假设是，与健全的跑步者相比，使用RSP跑步会对ILEA的完整肢体造成更大的应变，这是通过关节动力学适应来测量的。这项研究计划的长期目标是描述ILEA跑步的特征，并将这些发现作为科学基础，以制定RSP和康复策略，最大限度地减少过度使用损伤的可能性，同时最大限度地提高ILEA的健康和生活质量。

DESCRIPTION (provided by applicant): Over 1.6 million people live with limb loss in the United States, and 80,000 to 90,000 lower limb amputation surgeries are performed each year in this country alone. Locomotion eases our ability to perform our everyday activities at home, work, and in the community, and it is imperative for individuals who undergo lower extremity amputations to achieve locomotive levels to maximize quality of life. Early studies on "functional capabilities" of individuals with lower extremity amputations (ILEA) found that the most difficult physical activity was running. Recent developments of running-specific prostheses (RSPs) have attracted many ILEA to choose running as their form of cardiovascular exercise and it is likely that the cardiovascular benefits of running reported in prior studies extend to this population. However, the impact forces and mechanical adaptations of running with an RSP may put this group at risk for physical injuries and degenerative joint diseases, as suggested by our preliminary data and previous studies. Our preliminary data on ILEA running show that the ground reaction forces recorded provide asymmetrical loading to the limbs with the intact limb bearing a greater load than the residual limb. This pattern was consistent at different running velocities. Asymmetrical limb loading has been indicated as a risk factor in the development and progression of degenerative joint diseases (DJD), but more specific data, such as adaptations in joint kinetics, are needed to better understand the mechanisms of DJD and overuse injuries. Unfortunately, a very limited number of studies provide insights into more specific mechanisms of joint loading and adaptations made by ILEA during running. Furthermore, no validated biomechanical models currently exist for joint kinetic analyses of ILEA running with RSPs. Our preliminary work has developed such a model and indicates that accurate joint kinetic measurements can be estimated and interpreted. Using this model we propose to assess the force transmission through the lower extremities and the biomechanical adaptations of ILEA running with RSPs. By systematically testing a range of running velocities, we will examine joint kinetic adaptations employed to achieve these velocities to compare and contrast ILEA adaptations to those of able-bodied control subjects. Our central hypothesis is that running with an RSP will cause greater strain on the intact limb of ILEA compared to able-bodied runners as measured by joint kinetic adaptations. The long-term objective of this research program is to characterize ILEA running and use these findings as a scientific foundation to develop RSPs and rehabilitation strategies that minimize the potential for overuse injury while maximizing the health and quality of life for ILEA.