Whole-Body Angular Momentum During Walking on Varied Surfaces in Individuals with

患有此病的个体在不同表面上行走时的全身角动量

• 批准号: 8634934
• 负责人: Anne Silverman
• 金额: $ 7.5万
• 依托单位: COLORADO SCHOOL OF MINES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-08 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8634934
• 关键词: Accounting; Activities of Daily Living; Address; Affect; Amputation; Amputees; Ankle; Biological; Biomechanics; Cessation of life; Clinical; Equilibrium; Exercise; Foundations; Future; Gait; Goals; Health; Individual; Injury; Joints; Kinetics; Knee; Life; Limb structure; Lower Extremity; Measures; Medical; Metabolic; Methods; Muscle; Pattern; Population; Positioning Attribute; Productivity; Prosthesis; Protocols documentation; Reaction; Recovery; Relative (related person); Research; Risk; Rotation; Self-Help Devices; Surface; Techniques; Testing; Time; Training; United States; Walking; Work; computer studies; cost; design; fall risk; falls; fear of falling; foot; improved; improved mobility; kinematics; limb amputation; locomotor tasks; muscle strength; neuromuscular; novel; patient population; public health relevance; research study; simulation

DESCRIPTION (provided by applicant): The number of individuals with unilateral transtibial amputation (TTA) is rapidly growing in the United States, and these individuals suffer from a variety of gait deficits, including a greater risk and fear of falling. Falls are a serious health problem, and account for approximately 30% of injury-related medical costs in the U.S. Walking on sloped surfaces and on stairs is frequently encountered in daily living activities and presents a greater risk of falling relative to walking on level ground, particularly for people with disabilties, such as individuals with amputation. Recently, whole-body angular momentum has been investigated during level, unimpaired walking, and must be regulated in order to maintain dynamic balance. Analysis of additional biomechanical measures, such as the external moment and margin of stability, can result in a comprehensive view for dynamic balance when combined with whole-body angular momentum. In addition, powered prostheses have recently become commercially available, and have shown promising results in reducing the metabolic cost of walking. However, the effects of functionally different prostheses on dynamic balance during walking on varied surfaces remain unclear. The proposed work aims to quantify dynamic balance in TTA using both passive and powered prostheses relative to non-amputees during walking on stairs and on sloped surfaces. Specific Aim 1: Quantify differences in whole-body angular momentum, external moment and margin of stability between TTA using a passive prosthesis, using a powered prosthesis and non-amputees during stair ascent and descent to determine the effects of functionally different prostheses on fall risk Specific Aim 2: Quantify differences in whole-body angular momentum, external moment and margin of stability between TTA using a passive prosthesis, using a powered prosthesis and non-amputees during incline and decline walking on slopes of zero, five and ten degrees to determine the effects of functionally different prostheses on fall risk. Through these specific aims, the effects of a lower limb amputation and functional changes in the prosthesis on dynamic balance will be determined. The angular momentum, external moment and margin of stability results will be further interpreted using joint kinetics to identify biomechanical mechanisms that may contribute to balance control. The proposed work provides a foundation to substantially extend this research to experimental and computational studies of balance control, muscle and prosthesis function, and altered prosthesis control strategies. In addition, the approach can be extended to additional patient populations. The long-term objectives of this work are to improve mobility, productivity and independence in individuals with lower-limb amputation by reducing fall risk.

描述（由申请人提供）：在美国，单侧经胫骨截肢（TTA）患者的数量正在迅速增长，这些患者患有各种步态缺陷，包括更大的跌倒风险和恐惧。福尔斯是一个严重的健康问题，并且在美国占与伤害相关的医疗费用的大约30%。在斜坡表面和楼梯上行走在日常生活活动中经常遇到，并且相对于在平地上行走，尤其是对于残疾人，例如截肢者，呈现更大的跌倒风险。最近，全身角动量已被调查水平，未受损的步行，必须进行调节，以保持动态平衡。分析额外的生物力学指标，如外部力矩和稳定性裕度，结合全身角动量，可以全面了解动态平衡。此外，动力假肢最近已经商业化，并且在减少行走的代谢成本方面显示出有希望的结果。然而，功能不同的假肢在不同表面上行走时对动态平衡的影响仍不清楚。拟议的工作旨在量化动态平衡TTA使用被动和动力假肢相对于非截肢者在楼梯上行走，并在倾斜的表面。具体目标1：量化使用被动假肢的TTA、使用动力假肢的TTA和非截肢者在上楼梯和下楼梯过程中的全身角动量、外部力矩和稳定性边缘的差异，以确定功能不同的假肢对跌倒风险的影响具体目标2：量化使用被动假体的TTA之间的全身角动量、外部力矩和稳定性边缘的差异，使用动力假肢和非截肢者在0度、5度和10度的斜坡上倾斜和倾斜行走，以确定功能不同的假肢对跌倒风险的影响。通过这些具体的目标， 将确定截肢和假体在动态平衡上的功能变化。将使用关节动力学进一步解释角动量、外部力矩和稳定性裕度结果，以确定可能有助于平衡控制的生物力学机制。拟议的工作提供了一个基础，大大扩展这项研究的平衡控制，肌肉和假肢功能，并改变假肢控制策略的实验和计算研究。此外，该方法可以扩展到其他患者人群。这项工作的长期目标是通过减少跌倒风险来改善下肢截肢者的活动能力、生产力和独立性。