Altered cumulative joint moments and increased joint moment symmetry during sit-to-stand transitions for transfemoral bone-anchored limb users: A case series

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-26 DOI:10.1016/j.clinbiomech.2025.106476

Peter B. Thomsen-Freitas , Jason W. Stoneback , James B. Tracy , Mohamed E. Awad , Danielle H. Melton , Brecca M.M. Gaffney , Cory L. Christiansen

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引用次数: 0

Abstract

Background

Sit-to-stand transitions are demanding activities for people with unilateral transfemoral amputation. Movement asymmetries during sit-to-stand place greater stresses on the intact limb joints compared to the amputated limb joints, potentially contributing to musculoskeletal overuse injury and pain. Bone-anchored limbs address socket-related prosthesis issues, but their impact on cumulative joint moments during sit-to-stand is yet to be fully understood. The purpose of this study was to investigate changes in cumulative joint moments and moment symmetry during sit-to-stand transitions among transfemoral bone-anchored limb users.

Methods

A case-series of eight participants who underwent secondary bone-anchored limb implantation surgery were included. Ten consecutive days of physical activity monitoring (daily sit-to-stand) and motion capture during a 5-times sit-to-stand task were collected preoperatively (using socket prosthesis) and 12-months postoperatively. Cumulative low back, hip, and knee joint moments ([absolute joint moment impulse] x [average daily sit-to-stand]) were calculated. Between-limb symmetry was assessed using the Normalized Symmetry Index. Longitudinal changes in cumulative joint moments and moment symmetry were estimated with Hedge's g effect sizes.

Findings

Medium-to-large effects (g > 0.5) were observed for increased frontal-plane amputated-limb hip moment and increased sagittal-plane cumulative low back and intact-limb knee moments. Small-to-medium effects (g < 0.5) were observed for improved between-limb frontal-plane hip moment symmetry.

Interpretation

Despite improved between-limb symmetry, persistent overloading of the intact limb was present one-year after bone-anchored limb implantation. Changes in loading without meaningful changes in average number of daily sit-to-stands suggest potential needs for advanced prosthetic component prescription and more effective movement pattern training for bone-anchored limb users.

查看原文本刊更多论文

经股骨骨锚定肢体使用者在坐姿到站立转换过程中累积关节力矩的改变和关节力矩对称性的增加：一个病例系列

背景：单侧经股截肢患者需要从坐姿到站立的转变。与截肢的肢体关节相比，坐姿到站立时的运动不对称对完整的肢体关节施加了更大的压力，可能导致肌肉骨骼过度使用损伤和疼痛。骨锚定肢体解决了与关节窝相关的假体问题，但它们对坐姿到站立过程中累积关节力矩的影响尚不完全清楚。本研究的目的是调查经股骨骨锚定肢体使用者在坐姿到站立转换过程中累积关节力矩和力矩对称性的变化。方法对8例接受二次骨锚定肢体植入术的患者进行病例分析。术前（使用假体）和术后12个月收集连续10天的身体活动监测（每天坐到站立）和5次坐到站立任务期间的动作捕捉。计算累积的腰背部、髋关节和膝关节力矩（[绝对关节力矩冲量]x[平均每日坐站立量]）。采用标准化对称指数评估肢间对称性。累积关节力矩和力矩对称的纵向变化用Hedge's g效应大小估计。研究结果：中大型效应(g >；0.5)，断肢前面髋关节力矩增加，矢状面累积腰背和完整肢膝关节力矩增加。中小型效应(g <；0.5)，改善了肢间前面髋关节力矩对称性。解释：尽管四肢间对称得到改善，但在骨锚定肢体植入一年后，完整肢体仍存在持续的超载。负荷的变化而每日从坐姿到站立的平均次数没有明显的变化，这表明可能需要先进的假体成分处方和对骨固定肢体使用者更有效的运动模式训练。

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

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.