Sansam Kate, Neumann Vera, O'Connor Rory, Bhakta Bipin
Academic Department of Rehabilitation Medicine, University of Leeds, Leeds, UK.
J Rehabil Med. 2009 Jul;41(8):593-603. doi: 10.2340/16501977-0393.
To investigate factors that predict walking with a prosthesis after lower limb amputation.
Systematic literature review.
A computer-aided literature search of MEDLINE, EMBASE, CINAHL and the Cochrane Library was performed to identify studies published up to August 2007 that investigated factors that predicted walking ability after lower limb amputation.
A total of 57 studies were selected. Predictors of good walking ability following lower limb amputation include cognition, fitness, ability to stand on one leg, independence in activities of daily living and pre-operative mobility. Longer time from surgery to rehabilitation and stump problems are predictors of poor outcome. The impact of the cause of amputation on walking varies between studies. In general, unilateral and distal amputation levels, and younger age were predictive of better walking ability. Sex probably does not have a significant influence on walking ability.
The heterogeneity of methods and outcome measures used in the identified studies make comparison difficult and, in part, explains conflicting conclusions in relation to predictive factors. Further investigation of predictive factors is needed to estimate walking potential more accurately and guide targeting of modifiable factors to optimize outcome after lower limb amputation.
探讨下肢截肢后使用假肢行走的预测因素。
系统文献综述。
利用计算机辅助检索MEDLINE、EMBASE、CINAHL和Cochrane图书馆，以识别截至2007年8月发表的研究，这些研究调查了下肢截肢后预测行走能力的因素。
共筛选出57项研究。下肢截肢后良好行走能力的预测因素包括认知、体能、单腿站立能力、日常生活活动独立性和术前活动能力。从手术到康复的时间较长以及残端问题是预后不良的预测因素。截肢原因对行走的影响在不同研究中有所不同。一般来说，单侧和远端截肢水平以及较年轻的年龄预示着更好的行走能力。性别可能对行走能力没有显著影响。
已识别研究中使用的方法和结果测量的异质性使得比较困难，部分解释了与预测因素相关的相互矛盾的结论。需要进一步研究预测因素，以更准确地估计行走潜力，并指导针对可改变因素的目标设定，以优化下肢截肢后的结果。
