Implication du membre inférieur sain dans les mécanismes d'adaptation de l'amputé trans-tibial à sa prothèse au cours de la marche

Abstract : The aim of this study was to describe adaptive mechanisms involving the intact limb during gait according to different prosthetic alignments. Three-dimensional gait analysis was conducted in 15 healthy subjects and 17 unilateral transtibial amputees in three conditions of prosthetic foot transverse rotation: initial alignment; initial alignment (IA) altered either by 6° of external rotation or by 6° of internal rotation (IR). Patients reported best comfort of gait in IA condition and discomfort in IR condition. In IA condition, during loading response of the intact limb, total knee work was increased compared to prosthetic limb and control group and total hip work was increased compared to control group. In addition, the sum of the total work exerted by the knee and hip joints in the intact limb was higher than in the prosthetic limb and in the control group. In uncomfortable IR condition, the total work exerted by the knee and the hip of the intact limb was further increased compared to IA condition, as well as the inter-limb dynamic asymmetry. These results suggest compensatory function of the intact limb in response to alteration of prosthetic alignment. This study opens the perspective of a simplified assessment of knee dynamics which in the process of adjusting prostheses.
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Constance Grumillier. Implication du membre inférieur sain dans les mécanismes d'adaptation de l'amputé trans-tibial à sa prothèse au cours de la marche. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2008. Français. ⟨NNT : 2008NAN10043⟩. ⟨tel-01777283⟩

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