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下肢截肢者的截肢与假肢调整。

Adjustments to amputation and an artificial limb in lower limb amputees.

作者信息

Sinha Richa, van den Heuvel Wim J A, Arokiasamy Perianayagam

机构信息

1Department of Community and Occupational Health, Research Institute SHARE, University Medical Centre Groningen, Groningen, the Netherlands.

出版信息

Prosthet Orthot Int. 2014 Apr;38(2):115-21. doi: 10.1177/0309364613489332. Epub 2013 May 30.

Abstract

BACKGROUND

Positive adjustments to amputation and an artificial limb play important roles in the rehabilitation process.

OBJECTIVES

To study the different facets of adjustments to amputation and an artificial limb in lower limb amputees and to assess the possible role of different background and amputation-related factors that could potentially influence these adjustments.

STUDY DESIGN

Cross-sectional.

METHODS

Adult unilateral and non-congenital lower limb amputees (n = 368) met the inclusion/exclusion criteria. Face-to-face interviews were conducted using structured questionnaires including patient's background, amputation and the Trinity Amputation and Prosthesis Experience Scales.

RESULTS

Amputees were on average satisfied with the functioning of the prosthesis, moderately psychosocially adjusted and not restricted in performing functional and social activities, except for athletic activities. Age, employment, daily use of prosthesis and assistive device use were the most important factors associated with adjustments to amputation and prosthesis, followed by gender, co-morbidity and amputation level.

CONCLUSIONS

Evaluation of employment status and measures to curb unemployment through vocational rehabilitation and providing assistance for placement should be intrinsic to the rehabilitation programme. Future studies are envisaged to understand the underlying factors determining the extent of daily use of prosthesis and the reasons for the use of assistive devices by the amputees. Clinical relevance Proper appraisal and measures to alleviate employment and co-morbidity, related issues, routine evaluation of daily use of prosthesis and providing appropriate gait training might facilitate immediate and long-term adjustment.

摘要

背景

对截肢和假肢的积极调适在康复过程中发挥着重要作用。

目的

研究下肢截肢者对截肢和假肢调适的不同方面,并评估可能影响这些调适的不同背景及与截肢相关因素的潜在作用。

研究设计

横断面研究。

方法

成年单侧非先天性下肢截肢者(n = 368)符合纳入/排除标准。采用结构化问卷进行面对面访谈,问卷包括患者背景、截肢情况以及三位一体截肢与假肢体验量表。

结果

截肢者总体上对假肢功能满意,在心理社会方面适度调适,除体育活动外,在进行功能和社交活动时不受限制。年龄、就业情况、假肢日常使用情况及辅助装置使用情况是与截肢和假肢调适相关的最重要因素,其次是性别、合并症和截肢水平。

结论

评估就业状况以及通过职业康复抑制失业并提供就业安置援助的措施应成为康复计划的固有组成部分。设想未来开展研究以了解决定假肢日常使用程度的潜在因素以及截肢者使用辅助装置的原因。临床意义 进行恰当评估并采取措施缓解就业及合并症相关问题、对假肢日常使用进行常规评估并提供适当的步态训练可能有助于实现即刻和长期调适。

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