From the Faculty of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran (MK, MTK); Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia (AE); and IUM University of Technology, Johor Bahru, Malaysia (HO).
Am J Phys Med Rehabil. 2013 Dec;92(12):1110-8. doi: 10.1097/PHM.0b013e31829b4b7a.
Lower-limb amputation is mainly a result of trauma, vascular disease, diabetes, or congenital disorders. Persons with amputation lose their ability to stand and walk on the basis of the level of amputation. Contribution of level of amputation, type of amputation, or cause of amputation to balance impairment has not been clearly defined. Furthermore, it is controversial how much the mentioned parameters influence standing stability. Therefore, the aim of this review article was to find the relationship between the abovementioned factors and balance impairment in the available literature. It was also aimed to find the possibility of improving standing stability by the use of different prosthesis components.
An electronic search was done via the PubMed, EMBASE, and ISI Web of Knowledge databases from 1960 to 2012. Quality of the articles was assessed using the Downs and Black tool.
On the basis of the used key words, 100 articles were found, of which 20 articles were selected in accordance with the selection criteria. The scores of reporting, external validity, internal validity (bias), and internal validity (confounding) varied between 4-9, 1-3, 3-5, and 2-6, respectively.
The literature review confirmed that standing stability of amputees depends on level of amputation, type of amputation, and cause of amputation. Moreover, prosthetic characteristics such as prosthetic ankle stiffness have influences on dynamic stability, whereas torsional adaptor does not have any positive influence on stability during level walking and on turning stability. Therefore, it can be concluded that the stability of a person with amputation can be improved by the use of appropriate prosthesis components.
下肢截肢主要是由于创伤、血管疾病、糖尿病或先天性疾病引起的。截肢者由于截肢的位置而丧失站立和行走的能力。截肢水平、截肢类型或截肢原因对平衡障碍的影响尚未明确界定。此外，上述参数对站立稳定性的影响程度仍存在争议。因此，本文综述的目的是在现有文献中寻找上述因素与平衡障碍之间的关系。同时，还旨在探讨通过使用不同的假肢组件来提高站立稳定性的可能性。
通过 PubMed、EMBASE 和 ISI Web of Knowledge 数据库进行电子检索，检索时间从 1960 年至 2012 年。使用 Downs 和 Black 工具评估文章的质量。
根据使用的关键词，共找到了 100 篇文章，其中有 20 篇文章符合选择标准。报告、外部有效性、内部有效性（偏倚）和内部有效性（混杂）的评分分别为 4-9、1-3、3-5 和 2-6。
文献综述证实，截肢者的站立稳定性取决于截肢水平、截肢类型和截肢原因。此外，假肢的特征，如假肢踝关节的刚度，对动态稳定性有影响，而扭转适应器对水平行走时的稳定性和转弯稳定性没有任何积极影响。因此，可以得出结论，通过使用适当的假肢组件，可以提高截肢者的稳定性。
