Kaastad T S, Tveter A T, Steen H, Holm I
Division of Orthopaedic Surgery, Oslo University Hospital, Rikshospitalet, Post Office Box 4956 Nydalen, 0424 Oslo, Norway.
Division of Orthopaedic Surgery, Oslo University Hospital, Rikshospitalet, Post Office Box 4956 Nydalen, 0424 Oslo, Norway and Institute of Physiotherapy, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, 0130 Oslo, Norway.
J Child Orthop. 2017 Oct 1;11(5):348-357. doi: 10.1302/1863-2548.11.170026.
The primary aim was to examine if there were differences in physical function and health-related quality of life (HRQoL) between young adults (18 to 35 years) with unilateral congenital lower-limb deficiency (CLLD) who had been surgically lengthened (Surg) and those using lengthening prostheses (Pros). Second, we wanted to compare their health status with an age- and gender-matched reference group (Ref) without CLLD.
Cross-sectional study including a study-specific questionnaire, clinical examination, two field tests evaluating physical function (the six-minute walk test and the Stair test) and HRQoL questionnaires (Short Form (SF)-36 and EuroQol (EQ)-5D-3L).
Physical function and HRQoL did not differ between the two treatment groups. The odds for having painful or disfiguring scars were 18 times higher in the Surg group (n = 16) compared with the Pros group (n = 14). The CLLD group showed significantly reduced physical function compared with the Ref group. HRQoL, measured by the EQ-5D-3L visual rating scale, was significantly reduced in the CLLD group compared with the Ref group, as was the SF-36 physical function domain in both genders. Men with CLLD also showed increased bodily pain and reduced general health (SF-36), while we found a reduction in the emotional role domain in women compared with Ref.
There were no significant differences in physical function and quality of life in young adults with CLLD treated with surgical lengthening compared with those using lengthening prostheses. Compared with the general Norwegian population, young adults with CLLD had significantly lower physical function and reduced HRQoL in some domains.
主要目的是研究接受手术延长治疗（手术组）的单侧先天性下肢缺失（CLLD）的年轻成年人（18至35岁）与使用延长假肢的年轻成年人（假肢组）在身体功能和健康相关生活质量（HRQoL）方面是否存在差异。其次，我们希望将他们的健康状况与年龄和性别匹配的无CLLD参考组（对照组）进行比较。
横断面研究，包括特定研究问卷、临床检查、两项评估身体功能的现场测试（六分钟步行测试和楼梯测试）以及HRQoL问卷（简短形式（SF）-36和欧洲五维度健康量表（EQ）-5D-3L）。
两个治疗组在身体功能和HRQoL方面没有差异。手术组（n = 16）出现疼痛或毁容性疤痕的几率比假肢组（n = 14）高18倍。与对照组相比，CLLD组的身体功能明显降低。用EQ-5D-3L视觉评定量表测量的HRQoL，CLLD组与对照组相比明显降低，两性的SF-36身体功能领域也是如此。患有CLLD的男性还表现出身体疼痛增加和总体健康状况（SF-36）下降，而与对照组相比，我们发现女性的情感角色领域有所下降。
接受手术延长治疗的CLLD年轻成年人与使用延长假肢的年轻成年人在身体功能和生活质量方面没有显著差异。与挪威普通人群相比，患有CLLD的年轻成年人在某些领域的身体功能明显较低，HRQoL也有所下降。
