跨步行水平和假肢装置对经股截肢者步态的节段间共变的不对称变化

N. Krausz, T. Flash
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引用次数: 0

摘要

在人类运动过程中,运动学冗余的解决方案以前是由节间协调定律描述的。这个定律描述了在步态过程中大腿、小腿和脚的仰角是如何变化的。先前的研究表明,共变平面(CVP)方向可以为帕金森病(PD)和小脑共济失调(CA)等步态病理提供见解。与其他运动病理相比,我们评估了膝关节以上截肢患者运动时的节段间CVP,表明截肢者确实遵循节段间协调规律。具体来说,我们考虑了不同行走能力(K水平)和膝关节和踝关节假体的运动。我们的研究结果表明,与对侧腿相比,截肢腿的CVP随步行速度的变化存在不对称性。此外,我们还表明,使用某些踝关节和膝关节假体时,对侧腿的CVP随速度的变化与健全受试者相似;对于被截肢的腿来说,情况就不同了。重要的是,这一结果可能对减少使用假肢行走的能量消耗有影响。此外,使用形状评分,我们提出了一个重要的结果,表明截肢者的步态似乎比PD或CA受试者更不协调。未来的工作将进一步扩大,以更好地了解截肢者的协调能力有何不同,以及动力假肢是否能改善这种协调能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Asymmetric Changes in Intersegmental Covariation Across Ambulation Levels and Prosthetic Devices for Transfemoral Amputee Gait
Resolution of kinematic redundancies during human locomotion has previously been described by the law of intersegmental coordination. This law describes how elevation angles of the thigh, shank, and foot covary during gait. Previous work showed that the covariation plane (CVP) orientation can provide insight into gait pathologies such as Parkinson's Disease (PD) and Cerebellar Ataxia (CA). We assess the intersegmental CVP for locomotion with an above knee amputation, as compared to other movement pathologies, showing that amputees do follow the law of intersegmental coordination. Specifically here we considered locomotion across different ambulation capacities (K level) and knee and ankle prostheses. Our results showed that there is an asymmetry in how the CVP varies with walking speed for the amputated leg versus the contralateral leg. Also, we showed that with certain ankle and knee prostheses the CVP of the contralateral leg varies with speed similarly to able-bodied subjects; this is not the case for the amputated leg. Importantly, this result may have implications for reduction of the energetic cost of walking with a prosthesis. Additionally, using the shape score, we present an important result showing that amputee gait seems to be more poorly coordinated than that of PD or CA subjects. Future work will be expanded to better understand how coordination differs in amputee subjects and whether powered prostheses improve this coordination.
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