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Effect of alignment changes on sagittal and coronal socket reaction moment interactions in transtibial prostheses

机译:对齐方式变化对胫骨假体矢状和冠状窝反应力矩相互作用的影响

摘要

Alignment is important for comfortable and stable gait of lower-limb prosthesis users. The magnitude of socket reaction moments in the multiple planes acting simultaneously upon the residual limb may be related to perception of comfort in individuals using prostheses through socket interface pressures. The aim of this study was to investigate the effect of prosthetic alignment changes on sagittal and coronal socket reaction moment interactions (moment-moment curves) and to characterize the curves in 11 individuals with transtibial amputation using novel moment-moment interaction parameters measured by plotting sagittal socket reaction moments versus coronal ones under various alignment conditions. A custom instrumented prosthesis alignment component was used to measure socket reaction moments during walking. Prosthetic alignment was tuned to a nominally aligned condition by a prosthetist, and from this position, angular (3° and 6° of flexion, extension, abduction or adduction of the socket) and translational (5. mm and 10. mm of anterior, posterior, medial or lateral translation of the socket) alignment changes were performed in either the sagittal or the coronal plane in a randomized manner. A total of 17 alignment conditions were tested. Coronal angulation and translation alignment changes demonstrated similar consistent changes in the moment-moment curves. Sagittal alignment changes demonstrated more complex changes compared to the coronal alignment changes. Effect of sagittal angulations and translations on the moment-moment curves was different during 2nd rocker (mid-stance) with extension malalignment appearing to cause medio-lateral instability. Presentation of coronal and sagittal socket reaction moment interactions may provide useful visual information for prosthetists to understand the biomechanical effects of malalignment of transtibial prostheses.
机译:对准对于下肢假肢使用者的舒适和稳定步态很重要。同时作用于残余肢体的多个平面中的插槽反应力矩的大小可能与通过插槽界面压力使用假体的个人对舒适感的感知有关。这项研究的目的是研究假体对齐方式变化对矢状和冠状窝反应力矩相互作用(力矩-力矩曲线)的影响,并使用通过绘制矢状面测量的新颖力矩-力矩相互作用参数表征11例胫骨截肢患者的曲线。在各种对准条件下,套筒反应力矩与冠状反应力矩的关系。使用定制的假体对齐组件来测量步行过程中的插槽反应力矩。假肢的调整由假肢调整到名义对准的状态,从这个位置开始,角度(3°和6°屈曲,伸展,外展或内收窝)和平移(5. mm和10. mm,在矢状面或冠状面上以随机方式进行牙槽窝的后,中或外侧平移对准变化。总共测试了17个对齐条件。冠状角和平移对齐方式的变化在力矩矩曲线中显示出相似的一致变化。与冠状位的变化相比,矢状位的变化表现出更复杂的变化。在第二个跷板(中位)期间,矢状角度和平移对力矩矩曲线的影响是不同的,伸展错位似乎会引起中外侧不稳定。冠状和矢状窝反应力矩相互作用的呈现可为假肢医师提供有用的视觉信息,以了解其变形的生物力学效应。

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