Highsmith M Jason, Kahle Jason T, Bongiorni Dennis R, Sutton Bryce S, Groer Shirley, Kaufman Kenton R
School of Physical Therapy & Rehabilitation Sciences, College of Medicine, University of South Florida, Tampa, Florida, USA.
Prosthet Orthot Int. 2010 Dec;34(4):362-77. doi: 10.3109/03093646.2010.520054. Epub 2010 Oct 24.
The purpose of this paper was to review the literature through a structured literature review and provide a grade of recommendation for patient safety, gait energy efficiency, and cost effectiveness of the C-Leg microprocessor-controlled prosthetic knee for transfemoral amputees. Medline (Ovid) and CINAHL (EBSCO) data bases were searched to identify potentially pertinent studies within the 1995-2009 time range. Studies were screened and sorted. Pertinent studies were rated for methodologic quality and for risk of bias. Following assessment of methodologic quality and bias risk, the level of evidence and a grade of recommendation was determined for each of three categories: Safety, energy efficiency, and cost effectiveness. A total of 18 articles were determined to be pertinent: seven for safety, eight for energy efficiency, and three for cost effectiveness. Methodologic quality was low with a moderate risk of bias in the safety and energy effectiveness categories. Studies in cost effectiveness received high scores for methodologic quality. Though methodologic quality varied across the selected topics, there was sufficient evidence to suggest increased efficacy of the C-Leg in the areas of safety, energy efficiency and cost when compared with other prosthetic knees for transfemoral amputees.
本文的目的是通过结构化文献综述对相关文献进行回顾，并针对经股骨截肢患者使用的C-Leg微处理器控制假肢膝关节的患者安全性、步态能量效率和成本效益给出推荐等级。检索了Medline（Ovid）和CINAHL（EBSCO）数据库，以识别1995 - 2009年时间范围内可能相关的研究。对研究进行筛选和分类。对相关研究的方法学质量和偏倚风险进行评分。在评估方法学质量和偏倚风险后，针对安全、能量效率和成本效益这三个类别分别确定证据水平和推荐等级。总共确定了18篇相关文章：7篇关于安全性，8篇关于能量效率，3篇关于成本效益。安全和能量效率类别的方法学质量较低，存在中度偏倚风险。成本效益方面的研究在方法学质量上得分较高。尽管所选主题的方法学质量各不相同，但有足够的证据表明，与其他经股骨截肢患者使用的假肢膝关节相比，C-Leg在安全性、能量效率和成本方面的效果有所提高。
