单侧大腿截肢者步行能力研究  

Walking Ability of Amputees with Unilateral Transfemoral Prosthesis

作　　者：刁子龙 曹学军[1,2] 杨平[1,2] 蔡丽飞[1,2] 

机构地区：[1]首都医科大学康复医学院,北京市100068 [2]中国康复研究中心北京博爱医院康复工程研究所,北京市100068

出　　处：《中国康复理论与实践》2015年第4期470-474,共5页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨单侧大腿截肢者步行能力的特点。方法选择单侧大腿截肢者16例为实验组,健康成年人16名为对照组,分别进行室内6 min步行能力测试、室外1000 m复杂路面步行能力测试、平衡测试和能量消耗测试。结果室内6 min步行能力测试中,实验组步速、步频、跨步长低于对照组(P<0.05),步态周期时间、能量消耗高于对照组(P<0.05),单支撑期时间、双支撑期时间和单/双比例均存在显著性差异(P<0.05)。平衡测试中,重心轨迹面积、重心轨迹长度、X最大偏移量和Y最大偏移量两组间无显著性差异(P>0.05)。室外1000 m步行测试完成时间和能量消耗存在显著性差异(P<0.05)。穿戴流体控制膝关节的截肢者,室内6 min步行能量消耗与室外1000 m能量消耗与穿戴机械四连杆膝关节的截肢者无显著性差异(P>0.05),但室内6 min步行距离与室外1000 m完成时间存在显著性差异(P<0.05)。结论单侧大腿截肢者步态缺乏效率,能量消耗大,平衡功能尚可。不同类型假肢膝关节可能对患者步行能力发生影响。Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Methods 16 unilateral transfemoral amputees（patients） and 16 healthy adults（controls） were tested with 6-minute walking test indoor, 1000 m walking outdoor on various terrain, balance test and energy expenditure test. Results The speed, frequency and stride length were significantly less in the patients than in the controls（P〈0.05） in the indoor 6-minute walking test, and the cycle of gait and energy expenditure were significantly more（P〈0.05）; single support time, double and single/double support time were different（P〈0.05）. In balance tests, there was no significant difference in the total track length, confidence ellipse area, maximum horizontal deviation and maximum vertical deviation between the patients and the controls（P〈0.05）. There were significant differences in time and energy expenditure of outdoor 1000 m walk test between two groups（P〈0.05）. There were significant differences in time of outdoor 1000 m walk test and distance of indoor walking test between amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint（P〈0.05）, but not in energy expenditure of indoor and outdoor walking test. Conclusion The amputees with unilateral transfemoral prosthesis appear the inefficient in gait,and expend more energy. Their balance remains well. The transfemoral prosthesis the amputees wore may impact their walking ability.

关 键 词：大腿截肢 大腿假肢 步行 康复 评定 

分 类 号：R687.5[医药卫生—骨科学]