Whole-body angular momentum during sloped walking using passive and powered lower-limb prostheses

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• 作者：Nathaniel T. Pickle^a ; Jason M. Wilken^b ; Jennifer M. Aldridge Whitehead^b ; Anne K. Silverman^a ; ^{asilverm@mines.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Biomechanics ; Uphill ; Downhill ; Amputee ; Falls ; Dynamic balance
• 刊名：Journal of Biomechanics
• 出版年：2016
• 出版时间：3 October 2016
• 年：2016
• 卷：49
• 期：14
• 页码：3397-3406
• 全文大小：754 K

文摘

Sloped walking requires altered strategies for maintaining dynamic balance relative to level-ground walking, as evidenced by changes in sagittal-plane whole-body angular momentum (H) in able-bodied individuals. The ankle plantarflexor muscles are critical for regulating H, and functional loss of these muscles from transtibial amputation affects this regulation. However, it is unclear if a powered prosthesis, which more closely emulates intact ankle function than a passive energy-storage-and-return prosthesis, affects H differently during sloped walking. Therefore, our purpose was to investigate H in individuals with unilateral transtibial amputation when using powered and passive prostheses. Overall, the range of H was greater in people with a transtibial amputation relative to able-bodied individuals. On a −10° decline, individuals with amputation did not decrease H as much as able-bodied individuals, and had reduced prosthetic limb braking ground reaction forces and knee power absorption. On a +10° incline, individuals with amputation had a greater relative increase of H than able-bodied individuals, a more anterior placement of the prosthetic foot, and higher peak hip power generation. The powered prosthesis condition resulted in a smaller range of H during prosthetic stance relative to the passive condition, although it was still larger than able-bodied individuals. Our results suggest that prosthetic ankle power generation may help regulate dynamic balance during prosthetic stance, but alone is not sufficient for restoring H to that of able-bodied individuals on slopes. Contributions of knee extensor muscles and the biarticular gastrocnemius in regulating H on slopes should be further investigated.