Abstract：
BACKGROUND: In the process of transtibial prosthetic fitting, alignment is the process of positioning the prosthetic foot relative to the residual limb. Changes in frontal plane alignment can impact knee moments during walking, which can either cause or, when aligned properly, prevent injuries. However, clinical evaluation of dynamic knee moments is challenging, limiting prosthetists\' insights into dynamic joint loading. Typically, knee joint loading is assessed in static stance using the knee moment arm as a proxy for subsequent dynamic alignment. It remains uncertain if static alignment accurately represents actual dynamics during walking.
OBJECTIVE: Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
METHODS: In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson\'s correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
RESULTS: The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p<0.001; Second: r=0.62, r2=38%, p=0.001) and knee adduction moment (First: r=0.42, r2=17%, p=0.030; Second: r=0.59, r2=35%, p=0.001). A 1 mm between-subject difference in static knee moment arm corresponded, on average, with a 0.9% difference in knee adduction moment at the first peak and a 1.5% difference at the second peak of the ground reaction force.
CONCLUSIONS: While static alignment is important to optimize adduction moments during stance it may only partly mitigate excessive moments during gait. The fair correlation and limited percentage of explained variance underscores the importance of dynamic alignment in optimizing the body\'s dynamic load during walking.
OBJECTIVE: Is the frontal knee moment arm in stance predictive for the knee moment arm and external knee adduction moment during gait in transtibial bone-anchored prosthesis users?
METHODS: In this cross-sectional study, twenty-seven unilateral transtibial bone-anchored prosthesis users underwent data acquisition on the M-Gait instrumented treadmill. Static and dynamic measurements were conducted, and knee moment arm and external knee adduction moment were calculated. Pearson\'s correlation and linear regression analyses were performed to examine relationships between static and dynamic knee moment arms and external knee adduction moments.
RESULTS: The static knee moment arm showed significant associations with dynamic knee moment arm at the ground reaction force peaks (First: r=0.60, r2=35%, p<0.001; Second: r=0.62, r2=38%, p=0.001) and knee adduction moment (First: r=0.42, r2=17%, p=0.030; Second: r=0.59, r2=35%, p=0.001). A 1 mm between-subject difference in static knee moment arm corresponded, on average, with a 0.9% difference in knee adduction moment at the first peak and a 1.5% difference at the second peak of the ground reaction force.
CONCLUSIONS: While static alignment is important to optimize adduction moments during stance it may only partly mitigate excessive moments during gait. The fair correlation and limited percentage of explained variance underscores the importance of dynamic alignment in optimizing the body\'s dynamic load during walking.
摘要：
背景：在经胫骨假体装配的过程中，对准是相对于残肢定位假足的过程。额平面对齐的变化会影响行走过程中的膝盖力矩，这可能会导致或，当正确对齐时，防止受伤。然而,动态膝关节力矩的临床评估具有挑战性，限制假肢医生对动态关节负荷的见解。通常,膝关节载荷在静态姿势中使用膝关节力矩臂作为后续动态对准的代理进行评估。仍然不确定静态对准是否准确地代表行走期间的实际动态。
目的：经胫骨骨锚接假体使用者步态中的前膝力矩臂和外膝内收力矩是否能预测？
方法：在本横断面研究中，在M-Gait仪器跑步机上对27名单侧胫骨骨锚假体用户进行了数据采集。进行了静态和动态测量，并计算了膝关节力臂和外部膝关节内收力矩。进行了Pearson相关性和线性回归分析，以检查静态和动态膝关节力矩臂与外部膝关节内收力矩之间的关系。
结果：静态膝盖力矩臂在地面反作用力峰值处显示出与动态膝盖力矩臂的显着关联（首先：r=0.60，r2=35％，p<0.001；其次：r=0.62，r2=38%，p=0.001）和膝盖内收力矩（首先：r=0.42，r2=17％，p=0.030；第二：r=0.59，r2=35%，p=0.001)。对应的静态膝盖力矩臂的受试者之间的1毫米差异，平均而言,膝盖内收力矩在第一个峰值处差异为0.9％，在地面反作用力的第二个峰值处差异为1.5％。
结论：虽然静态对准对于优化站立时的内收力矩很重要，但它可能只能部分减轻步态过程中的过度力矩。合理的相关性和有限的解释方差百分比强调了动态对齐在优化步行过程中身体动态负荷方面的重要性。
目的：经胫骨骨锚接假体使用者步态中的前膝力矩臂和外膝内收力矩是否能预测？
方法：在本横断面研究中，在M-Gait仪器跑步机上对27名单侧胫骨骨锚假体用户进行了数据采集。进行了静态和动态测量，并计算了膝关节力臂和外部膝关节内收力矩。进行了Pearson相关性和线性回归分析，以检查静态和动态膝关节力矩臂与外部膝关节内收力矩之间的关系。
结果：静态膝盖力矩臂在地面反作用力峰值处显示出与动态膝盖力矩臂的显着关联（首先：r=0.60，r2=35％，p<0.001；其次：r=0.62，r2=38%，p=0.001）和膝盖内收力矩（首先：r=0.42，r2=17％，p=0.030；第二：r=0.59，r2=35%，p=0.001)。对应的静态膝盖力矩臂的受试者之间的1毫米差异，平均而言,膝盖内收力矩在第一个峰值处差异为0.9％，在地面反作用力的第二个峰值处差异为1.5％。
结论：虽然静态对准对于优化站立时的内收力矩很重要，但它可能只能部分减轻步态过程中的过度力矩。合理的相关性和有限的解释方差百分比强调了动态对齐在优化步行过程中身体动态负荷方面的重要性。
