This study accesses the effects of shoe heel heights on loading, muscle activity, and plantar foot pressure of trans-tibial amputees during standing. Five male subjects with unilateral trans-tibial amputation volunteered to participate in this study. Three pairs of shoes with zero, 20 mm, and 40 mm heel heights were used. The loading line of the prosthetic side, the plantar foot pressure, and the surface electromyography (EMG) of 10 muscles were simultaneously recorded. With increasing shoe heel heights during standing, the loading line of the prosthetic side shifted from the anterior to the posterior side of the knee center, the peak pressure was increased in the medial forefoot region, and the peak pressure was reduced in the heel region. The EMG of the medial and lateral gastrocnemius of the sound leg almost doubled and that of the rectus fomris, vastus lateralis, and vastus medialis of the prosthetic side increased to different extents with in- creasing heel heights from zero to 40 mm. These results show a high correlation with human physical behavior. Changing of the heel heights for trans-tibial amputees during standing actually had similar effects to altering the prosthetic sagittal alignment. The results suggest that an alignment change is necessary to accommodate heel height changes and that prosthesis users should be cautious when choosing shoes.
近年来减重步行训练（partial body weight support treadmill training,PBWSTT）在临床上的应用越开越广泛,它主要是用减重吊带使患者步行时下肢负重减少,借助于运动平板进行步行能力训练。在训练时一般需要两名治疗师,一名帮助患者腿摆动、支撑期患足跟着地，防止支撑期膝过伸。另一名帮助患者进行身体重心转移、髋伸展、骨盆旋转，并保持患者躯干的直立。自20世纪90年代初以来,国内外多家研究机构利用机器人技术相继开展了代替理疗师辅助患者自动完成减重步行康复训练的设备。利用这种康复训练机器人进行步行康复训练,不仅减轻了治疗师的工作强度,而且步行训练参数重复性好,时相指标可以准确设定，能够有效加快康复进程，提高疗效。
