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Die Bewegungsanalyse in der Exoprothetik der unteren Extremität – Möglichkeiten und Grenzen

Motion analysis in lower limb exoprosthetics—possibilities and limitations

  • Leitthema
  • Published:
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This article has been updated

Zusammenfassung

Hintergrund

Die Bewegungsanalyse hat in der Orthopädietechnik eine hohe Relevanz, da sie ein essenzieller Teil des Versorgungsprozesses ist. Die Dokumentation der Bewegung mittels Videos und anderen instrumentellen Methoden wird in der Orthopädietechnik immer bedeutsamer, da Gebrauchsvorteile von komplexen Versorgungen am besten durch eine strukturierte Beobachtung belegt werden können.

Prozedere

Einer Bewegungsanalyse sollte immer eine Anamnese und klinische Untersuchung vorausgehen, um funktionelle Einschränkungen der untersuchten Person zu detektieren und dadurch Zusammenhänge zu Gangabweichungen herstellen zu können. Dazu gehört auch eine Überprüfung des vorhandenen Hilfsmittels. Neben dem Gehen in der Ebene ist bei Versorgungen mit Exoprothesen auch das Überwinden von Alltagshindernissen wie Treppen und Rampen von Interesse. Zur umfangreicheren Ermittlung des Funktionsstatus bieten sich funktionelle Test an. Bei speziellen Fragestellungen, insbesondere zu kinetischen Größen, ist eine instrumentelle 3‑D-Ganganalyse indiziert.

Abstract

Background

Gait analysis is of high relevance in prosthetics as it is an essential part of the fitting process. The documentation of movement by means of videos and instrumented methods is becoming increasingly important in prosthetics as benefits of a complex prosthesis can best be shown by structured observation.

Procedure

A movement analysis should always be preceded by an anamnesis and clinical examination in order to detect functional limitations of the examined person and thus to establish correlations to gait deviations. Additionally, the orthopaedic aid should be evaluated as well. In addition to walking on level ground, walking on everyday obstacles such as stairs and ramps is also of interest when observing people using prosthetic limbs. Functional tests can be used to determine the functional status more comprehensively. An instrumental-3D gait analysis is indicated for specific questions, especially regarding kinetic parameters.

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Change history

  • 20 July 2023

    Die Abbildungen 3 und 4 wurden in der Darstellung angepasst.

Abbreviations

2MWT:

2‑Minuten-Gehtest

CoP :

Centre of pressure

ESAR :

Energy storing and returning

ESMAC :

European Society for Movement Analysis in Adults and Children

fps :

Frames per second

FSST :

Four Square Step Test

GAMMA :

Gesellschaft für die Analyse menschlicher Motorik und ihre klinische Anwendung

GCMAS :

Gait and Clinical Movement Analysis Society

GRF :

Ground reaction forces

LCI :

Locomotor Capability Index

MDR :

Medical device regulation

MRC :

Medical Research Council

PMS :

Post market surveillance

POGS :

Prosthetic Observational Gait Score

POM :

Performance-based outcome measures

PSFS :

Patient Specific Functional Scale

QUEST :

Quebec User Evaluation of Satisfaction with Assistive Technology

ROS :

Roll over Shape

SAT-PRO :

Satisfaction with Prosthesis Questionnaire

SCS :

Socket Comfort Score

TUG :

Timed up and Go Tests

UD :

Unified deformable segment

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Authors and Affiliations

  1. Abteilungen Technische Orthopädie und Bewegungsanalytik, Klinik für Orthopädie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland

    Daniel Walter Werner Heitzmann Dipl. Ing. (FH), Julia Block Dipl. Ing. (FH),  Sebastian I. Wolf & Merkur Alimusaj Dipl. Ing. (FH)

  2. Andreas Wentzensen Forschungsinstitut, BG Klinik Ludwigshafen, Ludwigshafen, Deutschland

    Ursula Trinler

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  1. Daniel Walter Werner Heitzmann Dipl. Ing. (FH)
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  2. Julia Block Dipl. Ing. (FH)
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  3. Ursula Trinler
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  4. Sebastian I. Wolf
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  5. Merkur Alimusaj Dipl. Ing. (FH)
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Corresponding author

Correspondence to Daniel Walter Werner Heitzmann Dipl. Ing. (FH).

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D.W.W. Heitzmann, J. Block, U. Trinler, S.I. Wolf und M. Alimusaj geben an, dass kein Interessenkonflikt besteht.

In diesem Beitrag werden Daten aus Bewegungsanalytischen Studien von Menschen dargestellt. Die Studien wurden im Einklang mit der Deklaration von Helsinki durchgeführt, alle Teilnehmer und Teilnehmerinnen wurden aufgeklärt und haben schriftlich zugestimmt. Es liegt ein positives Ethikvotum vor (Universität Heidelberg, Ethikkommission der Med. Fakultät Zeichen S‑048/2018).

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Heitzmann, D.W.W., Block, J., Trinler, U. et al. Die Bewegungsanalyse in der Exoprothetik der unteren Extremität – Möglichkeiten und Grenzen. Orthopädie 52, 631–642 (2023). https://doi.org/10.1007/s00132-023-04408-z

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  • DOI: https://doi.org/10.1007/s00132-023-04408-z

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