義足のInset・Outset アライメント評価における 義足足底荷重位置の主観的推定の有効性  [in Japanese] The effectiveness of the subjective inference of the prosthetic foot loading position in sole for inset-outset alignment evaluation  [in Japanese]

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Author(s)

    • 須田 裕紀 SUDA Hironori
    • 新潟大学大学院自然科学研究科|新潟医療福祉大学義肢装具自立支援学科 Graduate School of Science and Technology, Niigata University|Department of Prosthetics & Orthotics and Assistive Technology, Niigata University of Health and Welfare
    • 林 豊彦 HAYASHI Toyohiko
    • 新潟大学大学院自然科学研究科|新潟大学工学部福祉人間工学科 Graduate School of Science and Technology, Niigata University|Department of Biocybernetics, Faculty of Engineering, Niigata University
    • 前田 雄 MAEDA Yu
    • 新潟大学大学院自然科学研究科|新潟医療福祉大学義肢装具自立支援学科 Graduate School of Science and Technology, Niigata University|Department of Prosthetics & Orthotics and Assistive Technology, Niigata University of Health and Welfare
    • 髙橋 素彦 TAkAHASHI Motohiko
    • 新潟大学大学院自然科学研究科|新潟医療福祉大学義肢装具自立支援学科 Graduate School of Science and Technology, Niigata University|Department of Prosthetics & Orthotics and Assistive Technology, Niigata University of Health and Welfare
    • 東江 由起夫 AGARIE Yukio
    • 新潟医療福祉大学義肢装具自立支援学科 Department of Prosthetics & Orthotics and Assistive Technology, Niigata University of Health and Welfare

Abstract

本研究では,義足のアライメント調整に関する新たな評価法を提案する.臨床における義足のアライメント調整では,義肢装具士の評価とともに,切断者の足底荷重位置の主観的評価が用いられている.後者の評価がしやすいように,著者らは切断者が立位時における足底荷重位置を記録する評価票を考案した.この評価票の有効性を検証するために,本研究では,まず義足の内外側方向のアライメントを変化したとき,評価票の記録および下肢の主要な力学的パラメータに与える影響について調べた.下腿切断者5 名を用いた実験の結果,記録された主観的な足底荷重推定位置は,適切なアライメントでは,踵とつま先を結ぶ線分付近に存在したが,内外側方向に変化すると,それに対応して有意に偏位した(p < 0.01).足底荷重推定位置の偏位は,立位時の足幅を足踏みで決めた「自由立位」よりも,被験者ごとに足幅を規定した「規定立位」の方が明瞭であった.その偏位と相関する生体力学パラメータは床反力の側方成分だけであった.これらの結果は,足底荷重位置の評価票が内外側方向のアライメント評価に有効である可能性を示唆していた.

This paper proposes a novel sensory assessment for the alignment of tibial prosthesis. In clinical adjustment of the alignment, patient's sensory assessment of the loading position in sole is usually used as well as the evaluation of orthotist and prosthetist. In order to facilitate the afore-mentioned sensory assessment, we developed an assessment sheet in which patients can easily make a record of the loading position in sole in the standing position. In order to validate its clinical efficacy, we studied how the change of inset and outset alignment of the prosthesis affects the record in the assessment sheet and dominant biomechanical parameters of the lower limb. Experiments using 5 patients revealed that an appropriate alignment of the prosthesis tended to make recorded subjective loading position in sole closed to the line segment connecting the heal and toe, while an inset or outset malalignment tended to make it deviate significantly from the line segment in the lateral or medial direction, respectively (p < 0.01). The deviation was more conspicuous when standing foot position was determined by each patient's inherent breadth of the heels, than as the breadth determined by stamping. Biomechanical parameters statistically correlated to the deviation were merely the lateral component of the floor reaction force. All these results suggested that the assessment sheet of the loading position in sole could be effective for evaluating inset and outset alignment of the prosthesis.

Journal

  • Journal of the Society of Biomechanisms

    Journal of the Society of Biomechanisms 41(1), 27-34, 2017

    Society of Biomechanisms

Codes

  • NII Article ID (NAID)
    130006287964
  • Text Lang
    JPN
  • ISSN
    0285-0885
  • Data Source
    J-STAGE 
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