“Comparing the biomechanical response of users of an open-source powered knee and ankle prosthesis versus a passive prosthesis during ramp and stair ambulation”

IF 2.4 3区医学 Q3 BIOPHYSICS

Journal of biomechanics Pub Date : 2025-04-26 DOI:10.1016/j.jbiomech.2025.112732

Sixu Zhou , Sujay Kestur , Jairo Maldonado , Kinsey Herrin , Nicholas Fey , Aaron Young

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引用次数: 0

Abstract

Powered and passive knee-and-ankle prostheses can restore mobility for individuals with transfemoral amputation (TFA), but their effects on biological joints remain underexplored. Overuse of biological joints with prostheses may lead to chronic pain. This study compared biological joint work during ramp and stair ascent and descent for nine individuals with TFA using the powered prosthesis compared to the passive prosthesis. We hypothesized that the powered prosthesis would reduce positive mechanical work in ascent due to active knee extension and the negative mechanical work in descent due to controlled energy dissipation. In ascent, the powered prosthetic knee generated more positive work (p < 0.05), reducing sound-side hip joint work by 29.3 % (CI: [1.5 %, 57.1 %]; p = 0.041) on ramps and 22.8 % (CI: [7.2 %, 38.3 %]; p = 0.019) on stairs. The powered prosthesis reduced biological joint work by 50.6 % (CI: [2.7 %, 98.4 %]; p = 0.041) during swing phase on ramp ascent. In descent, the powered prosthetic ankle absorbed twice the negative work on ramps (CI: [164.9 %, 269.9 %]; p = 0.001) and 2.5 times on stairs (CI: [-73.5 %, 372.9 %]; p = 0.145) by acting as a virtual rotational damper instead of a spring. No significant reductions in biological work were seen in descent tasks, though magnitudes were generally lower. Overall, the powered knee provided biomechanical benefits in ramp and stair ascent, while the powered ankle provided mild benefits in ramp and stair descent. However, the intact joint work remains elevated compared to able-bodied individuals, highlighting the need for further prosthetic improvements.

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“比较开源动力膝关节和踝关节假体与被动假体使用者在坡道和楼梯行走时的生物力学反应”

动力和被动膝关节和踝关节假体可以恢复经股截肢（TFA）患者的活动能力，但其对生物关节的影响仍未得到充分研究。过度使用带有假体的生物关节可能导致慢性疼痛。本研究比较了9名TFA患者使用动力假体和被动假体在坡道和楼梯上升和下降时的生物关节活动。我们假设动力假体在上升时由于主动膝关节伸展而减少正的机械功，在下降时由于控制能量耗散而减少负的机械功。在上升过程中，动力假膝产生更多的正功(p <；0.05)，使髋关节声侧工作减少29.3% (CI: [1.5%, 57.1%]；坡道上p = 0.041)和22.8% (CI: (7.2%, 38.3%);P = 0.019)。动力假体使生物关节工作减少50.6% (CI: [2.7%, 98.4%]；P = 0.041)。在下降过程中，动力假肢脚踝吸收的负功是坡道上负功的两倍(CI: [164.9%, 269.9%]；楼梯上p = 0.001)和2.5倍(CI: (-73.5%, 372.9%);P = 0.145)，通过充当虚拟旋转阻尼器而不是弹簧。在下降任务中，生物工作没有明显减少，尽管幅度普遍较低。总的来说，动力膝盖在坡道和楼梯上升中提供了生物力学上的好处，而动力脚踝在坡道和楼梯下降中提供了轻微的好处。然而，与健全的人相比，完整的关节工作仍然很高，这表明需要进一步改进假肢。

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

Journal of biomechanics 生物-工程：生物医学

CiteScore

5.10

自引率

4.20%

发文量

345

审稿时长

1 months

期刊介绍： The Journal of Biomechanics publishes reports of original and substantial findings using the principles of mechanics to explore biological problems. Analytical, as well as experimental papers may be submitted, and the journal accepts original articles, surveys and perspective articles (usually by Editorial invitation only), book reviews and letters to the Editor. The criteria for acceptance of manuscripts include excellence, novelty, significance, clarity, conciseness and interest to the readership. Papers published in the journal may cover a wide range of topics in biomechanics, including, but not limited to: -Fundamental Topics - Biomechanics of the musculoskeletal, cardiovascular, and respiratory systems, mechanics of hard and soft tissues, biofluid mechanics, mechanics of prostheses and implant-tissue interfaces, mechanics of cells. -Cardiovascular and Respiratory Biomechanics - Mechanics of blood-flow, air-flow, mechanics of the soft tissues, flow-tissue or flow-prosthesis interactions. -Cell Biomechanics - Biomechanic analyses of cells, membranes and sub-cellular structures; the relationship of the mechanical environment to cell and tissue response. -Dental Biomechanics - Design and analysis of dental tissues and prostheses, mechanics of chewing. -Functional Tissue Engineering - The role of biomechanical factors in engineered tissue replacements and regenerative medicine. -Injury Biomechanics - Mechanics of impact and trauma, dynamics of man-machine interaction. -Molecular Biomechanics - Mechanical analyses of biomolecules. -Orthopedic Biomechanics - Mechanics of fracture and fracture fixation, mechanics of implants and implant fixation, mechanics of bones and joints, wear of natural and artificial joints. -Rehabilitation Biomechanics - Analyses of gait, mechanics of prosthetics and orthotics. -Sports Biomechanics - Mechanical analyses of sports performance.