The relationship of hip strength to walking and balance performance in unilateral lower limb prosthesis users differs by amputation level.

IF 2.2 4区 医学 Q1 REHABILITATION
PM&R Pub Date : 2024-08-09 DOI:10.1002/pmrj.13245
Andrew Sawers, Stefania Fatone
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引用次数: 0

Abstract

Background: Safe and efficient locomotion is a frequently stated goal of lower limb prosthesis users, for which hip strength may play a central yet poorly understood role. Additional research to identify associations between hip strength, balance, and mobility among transtibial and transfemoral prosthesis users is required.

Objective: To test whether residual and/or intact limb isometric hip strength was associated with lower limb prosthesis users' walking speed, endurance, and balance.

Design: Cross-sectional study.

Setting: Research laboratory.

Participants: Convivence sample of 14 transtibial and 14 transfemoral prosthesis users.

Methods: Multiple linear regression was used to evaluate the relationship between isometric measures of residual and intact limb hip strength and walking and balance performance.

Main outcome measurements: Measures of isometric hip muscle strength, including peak torque, average torque, torque impulse, and torque steadiness (i.e. consistency with which an isometric torque can be sustained) were derived from maximum voluntary hip flexion, extension, abduction and adduction torque signals collected with a motor-driven dynamometer. Walking speed, endurance, and balance were assessed by administering the 10-meter walk test, 2-minute walk test, Four Square Step Test, and Narrowing Beam Walking Test, respectively.

Results: Residual limb hip extensor max torque and abductor torque steadiness explained between 51% and 69% of the variance in transtibial prosthesis users' walking speed, endurance, and balance. In contrast, intact limb hip abductor torque impulse explained between 33% and 48% of the variance in transfemoral prosthesis users' walking speed, endurance, and balance.

Conclusions: Our results suggest that unilateral transtibial and transfemoral prosthesis users' walking and balance performance may depend on different hip muscles, and different facets of hip strength. Amputation level-specific hip strength interventions may therefore be required to improve walking and balance performance in unilateral transtibial and transfemoral prosthesis users. The "intact leg strategy" adopted by transfemoral prosthesis users may be due to a variety of prosthesis and biomechanical factors that limit the efficiency with which transfemoral prosthesis users can exploit the strength of their residual limb hip muscles while walking.

单侧下肢假肢使用者的髋部力量与行走和平衡能力的关系因截肢程度而异。
背景:安全、高效地运动是下肢假肢使用者经常提出的目标,而髋部力量可能在其中发挥着核心作用,但人们对这一作用的了解却很少。我们需要开展更多研究,以确定经胫和经股假肢使用者的髋部力量、平衡和活动能力之间的关联:测试残肢和/或完整肢体等长髋关节力量是否与下肢假肢使用者的行走速度、耐力和平衡能力有关:设计:横断面研究:研究实验室:14名经胫和14名经股假肢使用者:方法:采用多元线性回归评估残肢和完整肢体髋部肌力等长测量与步行和平衡表现之间的关系:髋关节等长肌力的测量指标包括峰值扭矩、平均扭矩、扭矩脉冲和扭矩稳定性(即等长扭矩的持续性),这些指标均来自使用电机驱动测力计收集的髋关节最大自主屈伸、外展和内收扭矩信号。步行速度、耐力和平衡能力分别通过10米步行测试、2分钟步行测试、四方步测试和窄梁步行测试进行评估:结果:残存肢体髋关节伸肌最大扭矩和外展肌扭矩稳定性解释了经胫假肢使用者行走速度、耐力和平衡能力差异的51%到69%。与此相反,完整肢体髋关节外展肌扭矩脉冲可解释经股假肢使用者行走速度、耐力和平衡能力差异的 33% 至 48%:我们的研究结果表明,单侧经胫和经股假肢使用者的行走和平衡表现可能取决于不同的髋部肌肉和不同的髋部力量。因此,可能需要针对截肢程度进行髋部力量干预,以改善单侧经胫和经股假肢使用者的行走和平衡能力。经股假肢使用者采取的 "完整腿策略 "可能是由于各种假肢和生物力学因素造成的,这些因素限制了经股假肢使用者在行走时利用残肢髋部肌肉力量的效率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
PM&R
PM&R REHABILITATION-SPORT SCIENCES
CiteScore
4.30
自引率
4.80%
发文量
187
审稿时长
4-8 weeks
期刊介绍: Topics covered include acute and chronic musculoskeletal disorders and pain, neurologic conditions involving the central and peripheral nervous systems, rehabilitation of impairments associated with disabilities in adults and children, and neurophysiology and electrodiagnosis. PM&R emphasizes principles of injury, function, and rehabilitation, and is designed to be relevant to practitioners and researchers in a variety of medical and surgical specialties and rehabilitation disciplines including allied health.
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