■在未受损的人类运动中,足踝复合体的矢状平面坡度适应是一种由神经运动控制驱动的运动功能,可支持直立姿势和向前行走。由于经胫骨截肢而导致的这种适应性丧失可能导致不稳定和补偿性运动,因为大多数市售的假肢脚不允许自动倾斜调整。已开发出一系列自适应坡度的脚(SAF),以促进在斜坡上行走时的仿生踝关节运动。这篇综述评估了当前文献,以评估SAF假体对单侧胫骨假体使用者倾斜步态性能的影响。
■四个数据库(PubMed,Embase,CINAHL,IEEEXplore)于2022年4月28日进行了相关文章的搜索。搜索关键词涵盖一般术语“经胫骨,\"\"截肢,\"\"斜坡,\"\"自适应,\"和\"步态\",并包括将SAF假体与非SAF假体状况进行比较的文章。提取数据进行分析,并根据结果对结果进行分组,以确定趋势并帮助解释坡度适应对步态的影响。
■在筛选的672篇文章中,24人符合选择标准,被纳入本综述,2009年至2022年出版。非SAF条件包括动态响应脚和SAF假体,适应性功能不活跃。结果包括生物力学变量(关节动力学,步态对称性,脚趾间隙),临床结果测量,和能量消耗。所有SAF都表现出某种形式的足踝坡度适应性,但对其他关节动力学的影响是不一致的。在所有报告研究中,与非SAF相比,使用SAF时,倾斜和下降行走期间的最小脚趾间隙更大。
■结果通常表明步态质量有所改善,comfort,与斜坡行走期间的非SAF相比,使用SAF的安全性和安全性。然而,研究中测试的SAF和步行梯度的变化突出了研究的必要性,以阐明特定设计的步行条件影响和优势。
■斜坡-自适应假脚可以通过增加最小脚趾间隙来改善用户的步态质量和舒适度并增强步态安全性。如果有适当的指示,经常遇到斜坡的患者应被视为SAF的潜在用户。
UNASSIGNED: In non-impaired human locomotion, sagittal-plane slope
adaptation of the foot-ankle complex is a volitional function driven by neuromotor control to support upright posture and forward ambulation. Loss of this
adaptation due to transtibial amputation can lead to instability and compensatory motions as most commercially-available prosthetic feet do not permit automatic slope adjustments. A selection of slope-adaptive feet (SAF) have been developed to promote biomimetic ankle motion while ambulating over slopes. This
review evaluated the current literature to assess the effects of SAF prostheses on sloped gait performance in unilateral transtibial prosthesis users.
UNASSIGNED: Four databases (PubMed, Embase, CINAHL, IEEE Xplore) were searched on April 28, 2022, for relevant articles. Search keywords covered the general terms \"transtibial,\" \"amputation,\" \"slope,\" \"adaptive,\" and \"gait\", and included articles comparing a SAF prosthesis to a non-SAF prosthesis condition. Data were extracted for analysis and results were grouped according to outcomes to identify trends and aid interpretation of slope
adaptation effects on gait.
UNASSIGNED: Of the 672 articles screened, 24 met the selection criteria and were included in this
review, published between 2009 and 2022. The non-SAF condition included dynamic response feet and SAF prostheses with the adaptability function inactive. Outcomes included biomechanical variables (joint dynamics, gait symmetry, toe clearance), clinical outcome measures, and energy expenditure. All SAF demonstrated some form of foot-ankle slope gradient adaptability, but effects on other joint dynamics were inconsistent. Minimum toe clearance during incline and decline walking was greater when using SAF compared to non-SAF in all reporting studies.
UNASSIGNED: Results generally suggest improvements in gait quality, comfort, and safety with use of SAF compared to non-SAF during slope walking. However, variations in tested SAF and walking gradients across studies highlight the need for research to elucidate walking condition effects and advantages of specific designs.
UNASSIGNED: Slope-adaptive prosthetic feet may improve user gait quality and comfort and enhance gait safety by increasing minimum toe clearance. Patients who encounter slopes regularly should be considered as potential users of SAF if indicated appropriately.