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下肢截肢患者的步行能力和生活质量:骨整合与接受腔假肢的比较。

Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses.

机构信息

Department of Rehabilitation Medicine, Radboud University Nijmegen Medical Centre, Nijmegen Centre of Evidence Based Practice, Nijmegen, The Netherlands.

出版信息

Arch Phys Med Rehabil. 2013 Nov;94(11):2174-8. doi: 10.1016/j.apmr.2013.05.020. Epub 2013 Jun 14.

Abstract

OBJECTIVE

To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses.

DESIGN

Prospective case-control study.

SETTING

University medical center.

PARTICIPANTS

Subjects (N=22) with transfemoral amputation (1 bilateral) referred to our center because of socket-related skin and residual limb problems resulting in limited prosthesis use. Their mean age was 46.5 years (range, 23-67y) and mean time since amputation was 16.4 years (range, 2-45y). Causes of amputation were trauma (n=20) and tumor (n=2).

INTERVENTION

Implantation of an osseointegration prosthesis (OIP).

MAIN OUTCOME MEASURES

Global score of the Questionnaire for Persons With a Transfemoral Amputation (Q-TFA), prosthesis use, 6-minute walk test (6MWT), Timed Up & Go (TUG) test, and oxygen consumption during treadmill walking.

RESULTS

With the socket prosthesis, the mean ± SD Q-TFA global score, prosthesis use, 6MWT, TUG, and oxygen consumption were 39±4.7 points, 56±7.9h/wk, 321±28m, 15.1±2.1 seconds, and 1330±310mL/min, respectively, and significantly improved with OIP to 63±5.3 points, 101±2.4h/wk, 423±21m, 8.1±0.7 seconds, and 1093±361mL/min, respectively.

CONCLUSIONS

Osseointegration is a suitable intervention for persons whose prosthesis use is reduced because of socket-related problems. Subjects with OIP significantly increased their walking ability and prosthesis-related quality of life.

摘要

目的

研究骨整合假肢与接受腔假肢相比的步行能力和生活质量。

设计

前瞻性病例对照研究。

地点

大学医学中心。

参与者

因接受腔相关皮肤和残肢问题导致义肢使用受限而转至本中心的股骨截肢(1 例双侧)患者(N=22)。他们的平均年龄为 46.5 岁(范围 23-67 岁),截肢后平均时间为 16.4 年(范围 2-45 年)。截肢原因包括创伤(n=20)和肿瘤(n=2)。

干预措施

植入骨整合假肢(OIP)。

主要观察指标

股骨截肢者问卷(Q-TFA)的总体评分、义肢使用、6 分钟步行试验(6MWT)、计时起立行走测试(TUG)和跑步机行走时的耗氧量。

结果

使用接受腔假肢时,Q-TFA 总体评分、义肢使用、6MWT、TUG 和耗氧量的平均(±SD)分别为 39±4.7 分、56±7.9 小时/周、321±28 米、15.1±2.1 秒和 1330±310mL/min,而使用 OIP 后分别显著改善至 63±5.3 分、101±2.4 小时/周、423±21 米、8.1±0.7 秒和 1093±361mL/min。

结论

对于因接受腔相关问题导致义肢使用减少的患者,骨整合是一种合适的干预措施。使用 OIP 的患者显著提高了他们的步行能力和与义肢相关的生活质量。

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