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基于便攜式步態(tài)測試儀的不同接受腔單側(cè)大腿截肢者行走特點(diǎn)研究 Research on walking characteristics of unilateral transfemoral amputees wearing prostheses with different socket based on the portable gait analyzer |
| 作者： 李松 靳飛 張寬 閆松華 |
| 單位：首都醫(yī)科大學(xué)生物醫(yī)學(xué)工程學(xué)院（北京 100069）<br />中國康復(fù)研究中心（北京 100068）<br />中國康復(fù)科學(xué)所(北京 100068)<br />臨床生物力學(xué)應(yīng)用基礎(chǔ)研究北京市重點(diǎn)實(shí)驗(yàn)室(北京 100069)<br />通信作者：閆松華，副教授。E-mail: yansh74@ ccmu.edu.cn |
| 關(guān)鍵詞： 單側(cè)大腿截肢；四邊形接受腔；坐骨包容接受腔；假肢；步態(tài)分析 |
| 分類號：R318 |
| 出版年·卷·期（頁碼）：2023·42·2（178-183） |
| 摘要： |
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目的 探討穿戴坐骨包容接受腔與四邊形接受腔大腿假肢的單側(cè)大腿截肢者在日常生活中行走時(shí)的步態(tài)差異，為臨床制定大腿假肢使用處方提供指導(dǎo)。方法 選取7位大腿截肢患者作為實(shí)驗(yàn)組，為患者分別適配四邊形和坐骨包容接受腔大腿假肢。同時(shí)選取7位年齡、性別、身高和體重相匹配的健康受試者作為對照組。所有受試者以舒適的步速在室外平路上行走240 m，應(yīng)用便攜式步態(tài)測試儀（intelligent device for energy expenditure and activity, IDEEA）采集步態(tài)數(shù)據(jù)，包括7個(gè)時(shí)空參數(shù)和4個(gè)加速度參數(shù)，通過IBM SPSS Statistics 23對數(shù)據(jù)進(jìn)行處理。對比患者穿戴兩種假肢與健康受試者之間、患者分別穿戴同種假肢時(shí)患側(cè)與健側(cè)之間、患者穿戴兩種假肢時(shí)患側(cè)之間，健側(cè)之間的參數(shù)差異。結(jié)果 與健康受試者相比，患者分別穿戴兩種假肢行走時(shí)，兩種假肢健側(cè)和患側(cè)的站立時(shí)間和步態(tài)周期顯著增大（P<0.05），步速、步頻、跨步長顯著減小（P<0.05）；兩種假肢患側(cè)的擺動時(shí)間顯著延長（P<0.05），地面沖擊和足落地控制顯著減小（P<0.05）；四邊形接受腔假肢雙側(cè)和坐骨包容接受腔假肢健側(cè)的單步時(shí)間顯著延長（P<0.05）。四邊形接受腔假肢患側(cè)擺動時(shí)間顯著長于健側(cè)（P=0.03）；坐骨包容接受腔假肢患側(cè)擺動時(shí)間顯著長于健側(cè)（P=0.02），地面沖擊顯著小于健側(cè)（P=0.04）。四邊形接受腔假肢患側(cè)的步態(tài)周期顯著長于坐骨包容接受腔假肢（P=0.01）；四邊形接受腔假肢健側(cè)的步態(tài)周期顯著長于坐骨包容接受腔假肢（P=0.03）。結(jié)論 患者穿戴兩種假肢在室外行走時(shí)，步行速度均明顯慢于健康受試者；患者步行過程中健側(cè)均有代償；患者穿戴坐骨包容接受腔假肢行走時(shí)的速度顯著快于穿戴四邊形接受腔假肢時(shí)的速度；患者穿戴坐骨包容接受腔假肢行走時(shí)假肢側(cè)在支撐期的穩(wěn)定性比穿四邊形接受腔假肢更好。 |
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To investigate the gait differences between unilateral transfemoral amputees with ischial containment prostheses and quadrilateral prostheses in daily life, in order to provide guidance for the formulation of prosthesis prescription for unilateral transfemoral amputees in clinic. Methods Seven participants with transfemoral amputees were selected as the test group. quadrilateral prostheses and ischial containment prostheses were made and well fitted with patients. At the same time, 7 healthy participants matched for age, sex, height, and weight were selected as the control group. All subjects walked 240 m on the flat road at a comfortable, self-selected velocity, at the same time the Intelligent device for energy expenditure and activity (IDEEA) was used to collect the gait parameters, including 7 spatiotemporal parameters and 4 acceleration parameters. Data were processed and analyzed by IBM SPSS Statistics 23, gait differences were compared between patients wearing two kinds of prosthetics and healthy people, between the affected sides or the healthy sides of patients wearing different prosthetics, and between the affected side and the healthy side of patients wearing same prosthetics. Results Compared with healthy subjects, when they walked on the flat road, for the patients, the standing duration and gait cycle were significantly increased (P<0.05); stride speed, stride frequency and stride length significantly decreased (P<0.05); the swinging duration of affected side of prostheses was significantly longer(P<0.05), ground impact and foot landing control decreased significantly(P<0.05); The single step time of quadrilateral prostheses and the healthy side of ischial containment prostheses was significantly longer (P<0.05). The swinging duration of affected side of quadrilateral prostheses was significantly longer than healthy side (P=0.03); The swinging duration of affected side of ischial containment prostheses was significantly longer than healthy side(P=0.02), ground impact was significantly lower than healthy side(P=0.04). The gait cycle of affected side of quadrilateral prostheses was significantly longer than ischial containment prostheses (P=0.01)；The gait cycle of healthy side of quadrilateral prostheses was significantly longer than ischial containment prostheses (P=0.03). Conclusions The walking speed of patients wearing prosthetics was significantly slower than healthy subjects. There were compensations on the healthy side during walking. Walking speed of participants with ischial containment prostheses was significantly faster than participants with quadrilateral prostheses. Ischial containment prostheses was more stable than quadrilateral prostheses during support period of affected side when walking. |
| 參考文獻(xiàn)： |
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[1] 趙燕潮. 中國殘聯(lián)發(fā)布我國最新殘疾人口數(shù)據(jù)[J]. 殘疾人研究, 2012(A01): 11. |
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