Mechanical Work and Metabolic Cost of Walking with Knee-Foot Prostheses: A Study with a Prosthesis Simulator

IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Irbm Pub Date : 2024-10-10 DOI:10.1016/j.irbm.2024.100863
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Abstract

Background

At equivalent speeds, above-knee amputee subjects have a higher metabolic cost than non-amputees. Following amputation, the ankle propulsion is reduced, and using other joints to compensate is mechanically less efficient.

Objective

This study investigated the link between mechanical work and metabolic cost in abled-bodied subjects using a prosthesis simulator, and the influence of foot energy restitution by comparing a foot with restitution to one without.

Method

Six volunteers fitted with an orthosis immobilising their ankle and knee, enabling the use of a prosthesis, carried out a gait analysis and an analysis of metabolic cost. The total lower limb mechanical work and works at the hip, knee and ankle were computed.

Results

With an almost twofold increase, metabolic cost and hip work were significantly higher in both configurations with prosthesis than without (p < 0.001 for both variables in both configurations), while total lower limb mechanical work showed no significant difference between configurations. No significant difference was observed between the two prosthetic feet in terms of metabolic cost nor mechanical work performed by the subject.

Discussion

Total lower limb mechanical work alone cannot explain the extra metabolic cost in subjects fitted with a knee-foot prosthesis simulator; internal inefficiencies exist. We also found that metabolic cost and hip work increase and decrease simultaneously, thus studying hip muscles work could be interesting. With no significant difference between the two feet, optimising ankle propulsion seems to be ineffective in improving metabolic cost. These findings should be evaluated in a sample of above-knee amputee subjects.

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膝足假肢行走的机械功和代谢成本:假肢模拟器研究
背景在同等速度下,膝上截肢者的代谢成本高于非截肢者。本研究使用假肢模拟器调查了健全受试者的机械功和代谢成本之间的联系,并通过比较有恢复功能的脚和没有恢复功能的脚,研究了脚部能量恢复的影响。方法六名志愿者安装了固定踝关节和膝关节的矫形器,以便使用假肢,并进行了步态分析和代谢成本分析。结果在两种配置中,安装假肢的代谢成本和髋关节功都明显高于未安装假肢的,几乎增加了两倍(两种配置中两个变量的P均为0.001),而下肢总机械功在不同配置中没有明显差异。讨论单凭下肢总机械功无法解释安装膝足假肢模拟器的受试者的额外代谢成本;内部存在低效率。我们还发现,代谢成本和髋关节做功同时增加和减少,因此研究髋关节肌肉做功可能很有意义。由于两只脚之间没有明显差异,优化踝关节的推进力似乎无法有效改善代谢成本。这些发现应在膝上截肢受试者样本中进行评估。
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来源期刊
Irbm
Irbm ENGINEERING, BIOMEDICAL-
CiteScore
10.30
自引率
4.20%
发文量
81
审稿时长
57 days
期刊介绍: IRBM is the journal of the AGBM (Alliance for engineering in Biology an Medicine / Alliance pour le génie biologique et médical) and the SFGBM (BioMedical Engineering French Society / Société française de génie biologique médical) and the AFIB (French Association of Biomedical Engineers / Association française des ingénieurs biomédicaux). As a vehicle of information and knowledge in the field of biomedical technologies, IRBM is devoted to fundamental as well as clinical research. Biomedical engineering and use of new technologies are the cornerstones of IRBM, providing authors and users with the latest information. Its six issues per year propose reviews (state-of-the-art and current knowledge), original articles directed at fundamental research and articles focusing on biomedical engineering. All articles are submitted to peer reviewers acting as guarantors for IRBM''s scientific and medical content. The field covered by IRBM includes all the discipline of Biomedical engineering. Thereby, the type of papers published include those that cover the technological and methodological development in: -Physiological and Biological Signal processing (EEG, MEG, ECG…)- Medical Image processing- Biomechanics- Biomaterials- Medical Physics- Biophysics- Physiological and Biological Sensors- Information technologies in healthcare- Disability research- Computational physiology- …
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Mechanical Work and Metabolic Cost of Walking with Knee-Foot Prostheses: A Study with a Prosthesis Simulator Corrigendum to “Transition Network-Based Analysis of Electrodermal Activity Signals for Emotion Recognition” [IRBM 45 (2024) 100849] Editorial Board Contents An Ensemble Learning System Based on Stacking Strategy for Survival Risk Prediction of Patients with Esophageal Cancer
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