Background: Obstacle crossing is an important activity of daily living, necessary to avoid tripping or falling, although it is not fully understood how transtibial amputees adapt to performing this activity of daily living following discharge from rehabilitation. Objectives: The objective of this study was to investigate the longitudinal adaptations in obstacle crossing in transtibial amputees post-discharge from rehabilitation.udStudy design: Longitudinal repeated measures.udMethods: Seven unilateral transtibial amputees crossed an obstacle 0.1m high positioned along a walkway while kinematic and kinetic data were recorded at 1, 3 and 6 months post-discharge.udResults: At 6 months post-discharge, walking velocity had increased (0.17 m.s−1) with most participants self-selecting an intact lead limb preference. During swing phase, peak knee flexion (p = 0.03) and peak knee power absorption (K4; p = 0.01) were greater with an intact versus affected lead limb preference. Having crossed the obstacle, intact limb peak ankle power generation in pre-swing (A2; p = 0.01) and knee power absorption (K3; p = 0.05) during stance phase were greater when compared to the affected limb.udConclusions: Obstacle crossing improved, although a greater reliance on intact limb function was highlighted. Results sug- gested that further improvements to locomotor performance may be obtained by increasing affected limb knee range of motion and concentric and eccentric strength of the knee extensors and flexors.ud
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机译：背景：越障是日常生活中的一项重要活动，是避免绊倒或跌倒所必需的，尽管尚不完全了解跨界截肢者在康复后如何适应这种日常生活活动。目的：本研究的目的是调查康复后出院的胫骨截肢者越过障碍物的纵向适应性。 ud研究设计：纵向重复措施。 ud方法：七名单侧胫骨截肢者越过障碍物并沿行人道高出0.1m ud结果：出院后6个月，步行速度增加了（0.17 ms-1），大多数参与者自行选择了完整的前肢偏好。在挥杆阶段，完整的膝关节屈曲峰值（p = 0.03）和最大的膝关节力量吸收（K4; p = 0.01）与受影响的前肢偏好有关。越过障碍物，与受影响的肢体相比，站立前肢的完整肢体峰值踝关节力量产生（A2; p = 0.01）和站立阶段的膝关节力量吸收（K3; p = 0.05）更大。尽管强调了对完整肢体功能的更大依赖，但这种情况有所改善。结果提示，通过增加患肢的膝关节活动范围以及膝伸肌和屈肌的同心和偏心强度，可以进一步改善运动性能。
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