関節アライメントを保つオープンソースの下腿義足バイパス：歩行学習と運動学的評価

原文アブストラクト

Prosthetic bypasses allow able-bodied individuals to walk with a prosthesis, enabling safe early-stage testing of new prosthetic devices before clinical trials. However, existing transtibial bypasses impose constraints, such as a contralateral shoe lift or a lateral offset of the prosthesis, and their effects on gait remain poorly documented. We present an open-source transtibial prosthetic bypass that preserves part of the sagittal knee mobility without these constraints. Six able-bodied participants familiarized themselves with the bypass for approximately 10~min, then walked on a treadmill with and without it, and joint kinematics were recorded with motion capture and then extracted with OpenSim. All participants were able to walk without handrail support, although single stance remained shorter on the bypass side (27% vs. 45% of the gait cycle). Bypass-side ankle kinematics were consistent with those reported for transtibial prosthesis users, whereas peak knee flexion during swing decreased from 61° to 36° (p<0.001) and hip range of the sound leg increased from 35° to 51° (p<0.01). Although gait with the bypass does not fully replicate that of prosthesis users, it yielded consistent gait patterns after only 10~min of learning. This bypass therefore provides a useful tool for the lower-limb prosthetics research community, facilitating preliminary experiments with able-bodied participants.