Força de Reação do Solo e atividade eletromiográfica da marcha de amputados transfemorais: uma série de casos

Abstract

-Ground reaction forces (GRF) and electromyographic activity form a part of the descriptive data that characterise the biomechanics of gait. The research of these parameters is important in establishing gait training and understanding the impact of amputation and prosthetic components on movement during the act of walking. Therefore, this case series describes the GRF and electromyographic activity in the gait of transfemoral amputees. A force plate was used to measure GRF, and an electromyographic system monitored the vastus lateralis, biceps femoris, tibialis anterior, and gastrocnemius lateralis muscles of the non-amputated leg. The average vertical and anteroposterior GRF time-curves, average electromyographic activity, and descriptor variables were then analysed. We observed decreases in vertical and anteroposterior GRF magnitudes as well as in anteroposterior GRF descriptor variables during the propulsive phase in the amputated leg. There were increases in phasic muscle activity and co-activation in the non-amputated leg. We concluded that, during walking, the unilateral transfemoral amputees (who were analysed in this case series) developed lower GRF in the amputated limb and a longer period of electromyographic activity in the non-amputated limb. Key words: Amputation; Biomechanics; Electromyography; Gait. Resumo -O comportamento da Força de Reação do Solo (FRS) e a atividade eletromiográ-fica formam uma parte dos dados que caracterizam a biomecânica da marcha. O estudo destes parâmetros é importante para a recuperação da locomoção e para compreensão do impacto da amputação e dos componentes protéticos nos movimentos desenvolvidos

The use of surface electromyography to assess transfemoral amputees: methodological and functional perspective

“…The selected studies had as main objectives: to investigate the electromyographic patterns of amputees using osteo fixed prostheses 7,8 , to verify possible changes and adaptations in muscle activation after amputation and prosthetization process 5,6,12,13 , to evaluate the kinematic and electromyographic variation of the muscles during gait 4,5,13 , to describe the behavior of ground reaction force and electromyographic activation 14 .…”

“…In addition to transfemoral amputees, one study also included participants with knee disarticulation 8 . Two studies did not include a control group for comparison 13,14 . Due to the characteristics of the sample studied, samples size was small, not only in the transfemoral group (min.…”

“…All studies, except for Cerqueira, Yamaguti, Mochizuki, Amadio, Serrão 14 , and Nakamura, Hahn 13 made comparisons with a control group that was composed of healthy individuals without amputation. However, it can be seen that amputated samples, for the most part, present great variation in the general characteristics, especially concerning to age, whereas the groups of controls have more homogenous characteristics.…”

“…However, it can be seen that amputated samples, for the most part, present great variation in the general characteristics, especially concerning to age, whereas the groups of controls have more homogenous characteristics. Although limb amputation is not uncommon, there are some limitations in bringing together similar individuals 5,14 . This observation may be related to the difficulty of recruitment of transfemoral amputees and to the specificities of this population, such as causes and time of amputation, adequate protection, functional level and stabilization in the individual's mass and residual stump volume 4,12 .…”

Análise Cinemática Linear e Angular da Marcha em Pacientes Amputados Transfemorais Protetizados

“…Considerando as principais diferenças entre o membro protetizado e sadio, foi possível verificar, na análise linear da marcha, que estes indivíduos possuem um comprimento e tempo do passo maior no lado amputado. Resultados que e apesar da sequência de ativação muscular ser a mesma, quando comparada com uma marcha normal, ela se torna mais longa 30 . Assim, entende-se porque o indivíduo amputado convive com diversos desafios, tais como o aumento do gasto energético, problemas de equilíbrio e de estabilidade 19 .…”