目的 探讨全骨盆切除术后胸廓承重接受腔和交互步态行走假肢的设计、装配和使用方法.方法 报道1例全骨盆切除术后患者.接受腔主要承重部位在下胸廓,悬吊依靠接受腔前后方向作用力,行走假肢由接受腔、交互步态行走矫形器的髋关节、假肢膝关节和SACH假脚组成,调节对线,进行步行训练.结果 患者借助接受腔直立每次可达4 h,借助腋拐可使用假肢以交互步态连续行走200 m,耗时30 min.改良Barthel指数评分由入院时的41.5分提高到出院时的93分(使用接受腔)和83分(使用假肢).结论 合理选择接受腔的受力位置、悬吊方式可以实现全骨盆切除者直立,合理选择假肢部件、正确力线和步行训练可以实现借助腋拐交互步态行走,从而提高日常生活活动能力.

Objective To study the design and fabricating method of orthosis for patients with leg length discrepancy. Methods Ischial weight bearing orthosis with prosthetic feet was made through efforts from weight,beauty and durabili-ty.The fabrication process included taking a negative plaster cast,modifying the positive model,forming,align-ment,and fitting the device to the patients. Results The orthosis was compensated for the patients'height with good appearance and convenience wearing. Conclusion Ischial weight bearing orthosis with prosthetic feet can help patients reconstruct walking function,therefore can be recommended.

Objective To analyze the podiatric conditions of athletes with intellectual disabilities.Methods From May eleventh to 17th, 2015,779 athletes who participated in the sixth National Special Olympics were enrolled partly.Their lower limbs and feet were evaluated with Fit Feet Healthy Athletes Screening Form.Results Common podiatric conditions found in Special Olympics athletes included flat feet (52.2% in left side and 51.7% in right side), over pronation (56.1% in left side and 56.9% in right side), callus (44.7%), wrong nail cut (46.6%),ingrown nail(21.1%),and cross over toes(6.8%),etc.Conclusion Special Olympics athletes have podiatric structural,functional, nail and skin problems,which may relate to intellectual disabilities.

Objective To compare the walking abilities of an unilateral transfemoral amputee with four different prosthetic knee joints, to provide a reference for clinical prosthetic prescription. Methods An unilateral transfemoral amputee was asked to wear four kinds of pros-thetic knee joints, mechanical four-bar, pneumatic four-bar, hydraulic and intelligent prosthetic knee joints, and evaluated with Timed Up and Go Test, indoor 6-Minute Walk Test, Static Stand Balance Test and a 1000-meter Outdoor Walking Ability Test, wearing Intelligent De-vice for Energy Expenditure and Activity. Results The amputee consumed the least energy and walked the fastest with intelligent prosthetic knee joint. Conclusion There are some difference in walking ability with different prosthetic knee joints.

Objective To investigate walking ability of amputees with unilateral transtibial prosthesis. Methods From April to Decem-ber, 2016, 20 unilateral transtibial amputees (patients) and 20 healthy adults (controls) were tested with L test, balance test, 6-minute walk test (6MWT) and 1000 m walking outdoor on various terrain. Results There was no significant difference in time of L test between the am-putees wearing Solid Ankle Cushion Heel (SACH) and Storage Foot (t=0.675, 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 (t<0.803, P>0.05). Each parameter was significantly different in 6MWT between them (t>2.774, P<0.01), as well as the time and energy expenditure of outdoor 1000 m walk test (t>4.130, P<0.001). Conclusion The walking ability of the unilateral transtibial ampu-tees wearing prostheses is different from normal people. The transtibial prosthetic feet that the amputees wear may impact their walking abil-ity.

Objective To systematically review the evaluation tools for walking ability of lower limb amputees wearing prostheses. Methods A computer-based search of PubMed, Wanfang Data and CNKI.net was performed for articles related to the evaluation of walking ability of lower limb amputees wearing prostheses published from January, 1995 to December, 2015. Results and Conclusion A total of 20 papers were selected, including 18 foreign literatures and 2 Chinese articles. There were many evaluation tools for walking ability of lower limb amputees wearing prostheses, and should be chosen according to the actual situation.

Objective To investigate the characteristics of walking ability of the amputees with unilateral transfemoral prosthesis. Meth-ods 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 significant-ly 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 sig-nificantly 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 be-tween 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 be-tween amputees wearing mechanical four-link prosthetic knee joint and fluid control prosthetic knee joint (P<0.05), but not in energy expen-diture 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.

With the development of the industry, all the parts of bilateral hip disarticulation prosthesis have been improved. The patients with bilateral hip disarticulation prosthesis can achieve the swing-to gait or swing-through gait, even the reciprocal gait.

Objective To compare the energy expenditure of a hemicorporectomy amputee moving with different mobility devices. Methods A middle-aged male hemicorporectomy amputee was measured with cardiopulmonary exercise test when moving with 4 kinds of transport:socket, cart, wheelchair, and prosthesis. Results The patient moved the slowest with prosthesis, fastest with wheelchair. The heart rate was the highest with prosthesis and lowest with cart. The absolute oxygen consumption, the relative volume of oxygen consumption and metabolic (Mets) were the most when hand walking with socket, and lowest with cart. Conclusion Hand walking with socket costs the larg-est energy when walking, and the rest are prosthesis, wheelchair, and cart.

Objective To compare the walking ability between bilateral transtibial amputees and normal controls, and develope refer-ence indexes of bilateral transtibial amptees' walking ability while wearing prostheses. Methods 11 bilateral transtibial amputees served as amputation group, 12 normal subjects served as controls. The indoor gait characteristics, outdoor time cost and energy consumption, and stat-ic balance of both groups were evaluated. Results After the indoor gait analysis, the average self-selected-speed of the amputees was 1.07 m/s, while the self-selected-speed of the normal people was 1.29 m/s. When the subjects walked with their self-selected-speed, there were significant differences in some of the gait spatial and temporal parameters between 2 groups (P<0.05). When the subjects walked on a spe-cially designed 1 km outdoor trail, differences of energy consumption and time cost were also observed (P<0.05). Static balance presented no significant difference between 2 groups (P>0.05). Conclusion The walking ability of the bilateral transtibial amputees wearing prosthe-ses is different from normal people. Quantitative evaluation of walking ability can provide more accurate reference for the rehabilitation of amputees.

The dysfunction of the upper limbs in tetraplegia depends on the level of spinal cord injury,and needs different type of upper limb orthosis.

Objective To design a weight-bearing pressure casting system for transtibial prostheses to make the total surface bearing socket and to control the stump and bearing during the casting process.MethodsThe weight-bearing pressure casting system was designed.6 cases weared the socket by this method and traditional patellar tendon bearing socket by hand casting.Socket interface pressure was compared,and the effect of casting was assessed.ResultsCompared with patellar tendon bearing socket,the socket pressure in the socked by this method was distributed more equally throughout the transtibial residual limb during the casting process,and completed the stumps compression and stump-end pressure control.ConclusionWeight-bearing pressure casting system can make the total surface bearing socket,and improve the fit of the socket.

Objective To design a reciprocal gait prosthesis connecting with the other prosthetic accessories for the bilateral hip disarticulation amputees.MethodsThe principle of reciprocal gait orthosis for paraplegia was used in the design,fitting reciprocal gait prosthesis for an amputee,which was compared with an ordinary bilateral Canadian type hip disarticulation prosthesis in the walking velocity and energy expenditure.ResultsThe amputee walked at lower energy expenditure and more like normal gait with reciprocal gait prosthesis while the walking velocity decreased,compared with the conventional prosthesis.ConclusionThis reciprocal gait prosthesis for bilateral hip disarticulation amputee needs less energy expenditure during walking like normal gait.

Objective To study a fast and feasible system in clinical application of computer aided socket design and manufacture.Methods The biomechanical index were compared of traditional hand-made prosthetic sockets and of computer aided design and manufacture ones based on 3D scanning and reverse engineering.Results The index from 3 cases wearing the computer aided design and manufacture socket prostheses appeared similar or better in static mechanical parameters,walking kinetic parameters and stump-socket interface pressure than they wearing traditional hand-made ones.Conclusion This computer aided socket design and manufacture system can meet patients' needs in using their prostheses.

The gradually developing study methods included the application of socket-limb interface stress test,socket computer aided design and manufacture,finite element method,the building of prosthesis 3D-rigid body kinetic model,gait analysis,and the footplate force system.

This paper reviewed the fabrication,clinical experience and biomechanics principle of foot orthoses used for the treatment of lower limb sports injuries.

This paper would review the effort of low limb orthoses on sports injury,especially the basic and clinical research in the treatment,rehabilitation and prevention.

Objective To investigate the geometric modeling method for trans-femoral prosthetic socket.Methods The socket reference shapes(i.e.shape templates) were constructed based on the statistic analysis and integrated into the CASD program.The initial socket shape was obtained by transformation from the corresponding reference shape based on the data from the patient's stump and the final socket shape was determined by a kind of three-dimensional interaction method under the OpenGL environment.The fabrication experiment is conducted on the specialized numerical control machine.Results The interactive modification method was easy to use.The machined socket mold is consistent with the designed model in the shape and the precision.Conclusion This method can meet the clinical requirements in the main,but need to optimize the surface shaping characters and rules during the interactive modification stage.

Objective To study the design and fabricating method,biomechanical effect and practicablity of the orthosis for patients suffering from large femoral bone defect and leg length discrepancy and study the effect of the orthosis on patients' equilibrium,walking function and gait.Methods By four stages we finally made ischial weight bearing orthosis with prosthetic feet,and then analysed its biomechanical effect and efficiency,evaluated balance and walking function of patients.Results The orthosis,according with principle of biomechanics,realized patients' wish of walking without crutch.The energy consumption and balanced capacity of patients wearing orthosis were much better while walking distance parameters came close to normal.Conclusion Ischial weight bearing orthosis with prosthetic feet can help patients reconstruct walking function,therefore can be recommended.