Influence of Ankle Motion on Bilateral Amputee Gait

踝关节运动对双侧截肢者步态的影响

• 批准号: 6471123
• 负责人: Steven A. Gard
• 金额: $ 27.5万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2005-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6471123
• 关键词: amputation; ankle; artificial limbs; assistive device /technology; bioenergetics; bioengineering /biomedical engineering; biomechanics; gait; human subject; knee; limb movement; medical rehabilitation related tag; patient oriented research; questionnaires; rehabilitation

We propose to investigate the effect of prosthetic ankle motion on the mechanics of bilateral lower-limb amputee gait. Bilateral lower-limb amputees often walk with rigid or stiff legs, which may be due in part to insufficient compliance and ranges of motion in their prosthetic ankles. They may attempt to overcome prosthetic deficiencies with compensatory actions that increase their energy expenditure during gait. Most of the literature pertaining to amputee gait is concerned with persons having unilateral amputations, but it is difficult to identify areas where significant improvement is needed based upon data from unilateral amputee gait. Compared with unilateral amputees, persons with bilateral leg amputations have a greater need for improvement in prosthetic componentry because of their increased energy demand as they walk and their low speed of walking. Prosthetic performance during gait is easier to evaluate in bilateral amputees because they have fewer physiological control options available to them while they ambulate. Few outcome studies have been reported in the literature regarding their rehabilitation, and there have been no published quantitative gait studies on bilateral leg amputees to date. We will perform quantitative gait analyses in the VA Chicago Motion Analysis Research Laboratory on 30 bilateral transtibial (below-knee) and transfemoral (above-knee) amputees walking with and without prosthetic components that increase ankle motion. These components include the Endolite Multiflex Ankle to increase ankle dorsiflexion/plantarflexion and inversion/eversion, and the Otto Bock Ankle Torsion Adapter to increase transverse plane rotation. We hypothesize that increased ankle motion will significantly improve the gaits of bilateral lower-limb amputees. We will also study simulated bilateral amputee gait in 15 able- bodied persons by fitting them with orthoses that minimize knee and ankle motion. We hypothesize that able-bodied persons walking with constrained ankles and knees will have gait characteristics similar to bilateral amputees. The able-bodied walking pattern serves as a useful basis of comparison for different types of pathological gait, and we believe that altering the locomotor system of the able-bodied person can yield valuable information concerning the mechanisms of pathological gait. The results from this study will aid in identifying limitations in current prosthetic technology that inhibit normal patterns of walking in amputees.

我们建议研究假肢运动对双侧下limb截肢步态力学的影响。双侧下limb amuputees经常以刚性或僵硬的腿行走，这可能部分是由于其假肢脚踝的依从性和运动范围不足。 他们可能会尝试通过补偿性行动来克服假肢缺陷，从而增加步态过程中的能量消耗。 与截肢步态有关的大多数文献都与单侧截肢的人有关，但是根据单方面截肢步态的数据，很难确定需要大幅改进的领域。 与单方面截肢者相比，双侧腿截肢的人更需要改善假体成分，因为他们走路时的能量需求增加和步行速度的低速。在步态过程中的假肢性能更容易在双侧截肢术中评估，因为它们在行动时可以使用的生理控制选择较少。 关于其康复的文献中，很少有结果研究报道，迄今为止，尚无关于双边腿截肢者的定量步态研究。我们将在VA芝加哥运动分析研究实验室进行定量步态分析，对30双双侧三阶（膝盖以下）和transhemoral（膝盖上）的宽度分子，而没有假体成分会增加脚踝运动。这些成分包括内载多反流脚踝，以增加踝背屈/plotharflexion和倒置/逆转，以及Otto Bock踝扭矩适配器以增加横平旋转。 我们假设增加的踝运动将显着改善双侧下limb截肢者的步态。我们还将通过使膝盖和脚踝运动最小化的矫形器安装矫形器，研究15个健美运动员的模拟双侧截肢步态。 我们假设身体健全的人以受约束的脚踝和膝盖行走的步态特征类似于双侧截肢者。 健全的步行模式是对不同类型病态步态的比较的有用基础，我们认为改变有能力的人的运动系统可以产生有关病理步态机制的有价值的信息。 这项研究的结果将有助于确定抑制截肢者正常行走模式的当前假体技术的局限性。