Transhumeral prosthesis use and disuse affects whole-body angular momentum

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-10-18 DOI:10.1016/j.clinbiomech.2024.106365

Julia A. Dunn , Nicholas G. Gomez , Bob Wong , Sarina K. Sinclair , K. Bo Foreman , Kent N. Bachus , Heath B. Henninger

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Abstract

Background

Individuals with transhumeral limb loss have an increased risk of falling, potentially resulting from altered upper-body kinematics during gait. The purpose of this study was to investigate whole-body angular momentum as a measure of movement control, to gain an understanding of how these upper-body kinematics contribute to dynamic balance.

Methods

Eight participants with transhumeral limb loss and eight able-bodied control participants completed three gait trials at self-selected speeds. The participants with transhumeral limb loss performed trials with and without their prosthesis. Coefficient of cancellation and whole-body angular momentum about all anatomical axes of rotation were calculated. Means and variance were compared across the conditions over the gait cycle via statistical parametric mapping, and ranges were compared using a one-way ANOVA.

Findings

Coefficient of cancellation was decreased between the upper/lower extremities in the transverse plane and between the upper extremities/trunk in the sagittal plane for both transhumeral walking conditions compared to the control group. Whole-body angular momentum was statistically different in the sagittal plane and decreased in the transverse plane when walking with the prosthesis compared to the control group. Walking without the prosthesis resulted in increased variability of whole-body angular momentum.

Interpretation

Individuals with transhumeral limb loss had dysregulated whole-body angular momentum compared to the control group. This dysregulation was related to decreased segment-to-segment cancellation from the upper extremities and increased variance throughout the gait cycle. Based on these findings, individuals should be encouraged to wear their transhumeral prosthesis while walking as it may reduce fall risk and fatigue.

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经肱骨假体的使用和废弃会影响全身角动量。

背景：经肱骨肢体缺失患者跌倒的风险增加，这可能是由于步态过程中上半身运动学发生了改变。本研究的目的是调查全身角动量作为运动控制的一种测量方法，以了解这些上半身运动学如何促进动态平衡：八名经肱骨肢体缺失的参与者和八名身体健康的对照组参与者以自选速度完成了三次步态试验。经桡侧肢体缺失的参与者分别在佩戴假肢和不佩戴假肢的情况下进行了试验。对所有解剖旋转轴的取消系数和全身角动量进行了计算。通过统计参数映射比较了步态周期内不同条件下的平均值和方差，并使用单因素方差分析比较了范围：结果：与对照组相比，两种经桡骨行走条件下的上肢/下肢之间在横向平面上的取消系数以及上肢/躯干之间在矢状平面上的取消系数均有所下降。与对照组相比，使用假肢行走时全身角动量在矢状面上有统计学差异，而在横向面上则有所减少。不戴假肢行走时，全身角动量的变异性增加：与对照组相比，经肱骨肢体缺失者的全身角动量失调。这种失调与上肢段与段之间的取消减少以及整个步态周期的变异增加有关。基于这些研究结果，应鼓励患者在行走时佩戴经桡骨假肢，因为这样可以减少跌倒风险和疲劳。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.