Article

Many trans-tibial amputees could not tolerate long-distance walking.
Lack of walking could explain for the increased cardiovascular diseases mortality
rate. This study investigated the effects of long-distance walking (LDW) on
socket-limb interface pressure, tactile sensitivity of the residual limb, and
subjective feedbacks, which potentially identified the difficulties in LDW.
METHOD: Five male unilateral trans-tibial amputees walked on a level treadmill
for a total of one hour at comfortable speed. Tactile sensitivity of the residual
limb and socket-limb interface pressure during over-ground walking were measured
before and after the treadmill walking. Modified Prosthesis Evaluation
Questionnaires were also administered. RESULTS: After the treadmill walking, the
socket-limb interface pressure and the tactile sensitivity at the popliteal
depression area were significantly reduced. This corresponds well with the
questionnaire results showing that the level of discomfort and pain of the
residual limb did not increase. The questionnaire revealed that there were
significant increases in fatigue level at the sound-side plantar flexors, which
could lead to impaired dynamic stability. CONCLUSIONS: Fatigue of sound-side
plantar-flexor was the main difficulty faced by the five subjects when walking
long-distances. This finding might imply the importance of refining prosthetic
components and rehabilitation protocols in reducing the muscle fatigue.
IMPLICATIONS FOR REHABILITATION: * After long-distance walking (LDW) of the
trans-tibal amputee subjects, there were significant increases in fatigue level
at the plantar flexors. These might explain the reduced walking stability as
perceived by the subjects. * LDW did not produce any problems in residual-limb
comfort and pain feeling. These were in line with the significant reductions of
socket-limb interface pressure and the tactile sensitivity at the popliteal
depression after LDW. * Refinements of prosthetic components and rehabilitation
protocols should be attempted to reduce the fatigue of the plantar flexors and
facilitate LDW.

Langue : ANGLAIS