Background

Movement asymmetries between lower limbs are commonly exhibited by adults after transtibial amputation. However, the degree of movement asymmetry between low- and high-demand functional tasks remains unknown.

Methods

Kinematic and kinetic data were collected during overground walking (low-demand) and step ascent (high-demand) tasks for two groups: 1) persons with transtibial amputation and 2) healthy matched peers. Analysis of covariance was used to compare sagittal-plane peak knee moment and joint angle (primary) and hip and ankle moments and joint angles, vertical ground reaction force and impulse (secondary).

Findings

Within transtibial amputation group comparisons showed significantly greater between-limb asymmetry in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .05), peak ankle angle (p < .01) and peak ankle moment (p < .01) with the step ascent task compared to overground walking. The transtibial amputation group had greater between-limb asymmetry during step ascent in peak knee moment (p < .01), vertical impulse (p < .01), peak vertical ground reaction force (p = .04) and peak ankle angle (p < .01) than healthy matched peers. During overground walking, the transtibial amputation group had greater between-limb asymmetry in peak vertical impulse (p = .05) and peak ankle moment (p < .01) than healthy matched peers.

Interpretation

Movement asymmetry is increased during step ascent compared to overground walking for adults with transtibial amputation. While the restoration of overground walking is the focus of post-amputation rehabilitation and prosthetic design, higher demand tasks should also be considered to maximize mobility for adults with transtibial amputation.

中文翻译：

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血管性胫骨截肢术后低要求和高要求运动任务中的运动不对称。

背景

小腿截肢后，成年人通常会表现出下肢之间的运动不对称。然而，低需求和高需求功能任务之间的运动不对称程度仍然未知。

方法

在地面行走（低需求）和阶梯上升（高需求）任务期间为两组收集了运动学和动力学数据：1) 小腿截肢患者和 2) 健康匹配的同龄人。协方差分析用于比较矢状面峰值膝关节力矩和关节角度（主要）以及髋关节和踝关节力矩和关节角度、垂直地面反作用力和冲量（次要）。

发现

在小腿截肢组比较中，膝关节峰值力矩 (p < .01)、垂直冲量 (p < .01)、垂直地面反作用力峰值 (p = .05)、踝关节峰值角度 (p < .01) 的肢体间不对称性显着增加.01) 和峰值脚踝力矩 (p < .01) 与地面步行相比的台阶上升任务。小腿截肢组在膝关节峰值力矩 (p < .01)、垂直冲量 (p < .01)、垂直地面反作用力峰值 (p = .04) 和踝关节峰值角度 (p < .01) 比健康匹配的同龄人。在地面行走期间，小腿截肢组在峰值垂直冲量 (p = .05) 和峰值脚踝力矩 (p < .01) 方面的肢体间不对称性高于健康匹配的同龄人。

解释

与小腿截肢成人的地面行走相比，在台阶上升过程中运动不对称性增加。虽然恢复地面行走是截肢后康复和假肢设计的重点，但还应考虑更高要求的任务，以最大限度地提高小腿截肢成人的活动能力。