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Evaluation of a quasi-passive biarticular prosthesis to replicate gastrocnemius function in transtibial amputee gait
Journal of Biomechanics ( IF 2.4 ) Pub Date : 2021-09-11 , DOI: 10.1016/j.jbiomech.2021.110749
Andrea M Willson 1 , Chris A Richburg 2 , Anthony J Anderson 1 , Brittney C Muir 1 , Joseph Czerniecki 3 , Katherine M Steele 4 , Patrick M Aubin 1
Affiliation  

Lower limb amputees experience gait impairments, in part due to limitations of prosthetic limbs and the lack of a functioning biarticular gastrocnemius (GAS) muscle. Energy storing prosthetic feet restore the function of the soleus, but not GAS. We propose a transtibial prosthesis that implements a spring mechanism to replicate the GAS. A prototype Biarticular Prosthesis (BP) was tested on seven participants with unilateral transtibial amputation. Participants walked on an instrumented treadmill with motion capture, first using their prescribed prosthesis, then with the BP in four different spring stiffness conditions. A custom OpenSim musculoskeletal model, including the BP, was used to estimate kinematics, joint torques, and muscle forces. Kinematic symmetry was evaluated by comparing the amputated and intact angles of the ankle, knee, and hip. The BP knee and ankle torques were compared to the intact GAS. Finally, work done by the BP spring was calculated at the ankle and knee. There were no significant differences between conditions in kinematic symmetry, indicating that the BP performs similarly to prescribed prostheses. When comparing the BP torques to intact GAS, higher spring stiffness better approximated peak GAS torques, but those peaks occurred earlier in the gait cycle. The BP spring did positive work on the knee joint and negative work on the ankle joint, and this work increased as BP spring stiffness increased. The BP has the potential to improve amputee gait compensations associated with the lack of biarticular GAS function, which may reduce their walking effort and improve quality of life.



中文翻译:

在胫骨截肢者步态中复制腓肠肌功能的准被动双关节假体的评估

下肢截肢者会出现步态障碍,部分原因是假肢的局限性和缺乏功能性双关节腓肠肌 (GAS) 肌肉。储能假脚恢复比目鱼肌的功能,但不能恢复 GAS。我们提出了一种通过弹簧机制复制 GAS 的胫骨假体。在 7 名单侧经胫骨截肢的参与者身上测试了原型双关节假体 (BP)。参与者在带有动作捕捉的仪器跑步机上行走,首先使用他们规定的假肢,然后在四种不同的弹簧刚度条件下使用 BP。一个定制的 OpenSim 肌肉骨骼模型,包括 BP,用于估计运动学、关节扭矩和肌肉力。通过比较踝关节、膝关节和髋关节的截肢角度和完整角度来评估运动学对称性。将 BP 膝关节和踝关节扭矩与完整的 GAS 进行比较。最后,在脚踝和膝盖处计算 BP 弹簧所做的功。运动对称性条件之间没有显着差异,表明 BP 的表现与规定的假肢相似。当将 BP 扭矩与完整 GAS 进行比较时,较高的弹簧刚度更好地接近峰值 GAS 扭矩,但这些峰值出现在步态周期的早期。BP 弹簧对膝关节做正功,对踝关节做负功,并且随着 BP 弹簧刚度的增加,这项功增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。BP 弹簧所做的工作是在脚踝和膝盖处计算的。运动对称性条件之间没有显着差异,表明 BP 的表现与规定的假肢相似。当将 BP 扭矩与完整 GAS 进行比较时,较高的弹簧刚度更好地接近峰值 GAS 扭矩,但这些峰值出现在步态周期的早期。BP 弹簧对膝关节做正功,对踝关节做负功,并且随着 BP 弹簧刚度的增加,这项功增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。BP 弹簧所做的工作是在脚踝和膝盖处计算的。运动对称性条件之间没有显着差异,表明 BP 的表现与规定的假肢相似。当将 BP 扭矩与完整 GAS 进行比较时,较高的弹簧刚度更好地接近峰值 GAS 扭矩,但这些峰值出现在步态周期的早期。BP 弹簧对膝关节做正功,对踝关节做负功,并且随着 BP 弹簧刚度的增加,这项功增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。表明 BP 的性能与规定的假肢相似。当将 BP 扭矩与完整 GAS 进行比较时,较高的弹簧刚度更好地接近峰值 GAS 扭矩,但这些峰值出现在步态周期的早期。BP 弹簧对膝关节做正功,对踝关节做负功,并且随着 BP 弹簧刚度的增加,这项功增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。表明 BP 的性能与规定的假肢相似。当将 BP 扭矩与完整 GAS 进行比较时,较高的弹簧刚度更好地接近峰值 GAS 扭矩,但这些峰值出现在步态周期的早期。BP 弹簧对膝关节做正功,对踝关节做负功,并且随着 BP 弹簧刚度的增加,这项功增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。并且这项工作随着 BP 弹簧刚度的增加而增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。并且这项工作随着 BP 弹簧刚度的增加而增加。BP 有可能改善与双关节 GAS 功能缺乏相关的截肢者步态补偿,这可能会减少他们的步行努力并提高生活质量。

更新日期:2021-09-27
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