Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, the Netherlands.
Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, the Netherlands.
PLoS One. 2019 Mar 20;14(3):e0213256. doi: 10.1371/journal.pone.0213256. eCollection 2019.
To systematically review the literature on the metabolic costs of activities of daily living (ADL) in persons with a lower limb amputation (LLA).
A literature search was undertaken in the Pubmed, Embase, CINAHL, CENTRAL, and PsycINFO databases using keywords and synonyms for LLA, metabolic costs, and ADL. The last search was performed on November 29th, 2017.
Studies were included if they met the following 2 criteria: participants were adults with a (unilateral or bilateral) LLA and metabolic costs were measured while participants performed a physical activity or ADL.
Data of 1,912 participants from 61 studies were included in the systematic review and meta-analysis. The studies used different terms to describe metabolic costs. Participants were recruited in different settings, relatively healthy, with few comorbidities. Limited data were available on metabolic costs of other activities than walking with a prosthesis. A linear mixed model analysis was performed based on the means reported, with study as unit of analysis and test results of different groups and measurement conditions as repeated measures within the unit of analysis. Predictors entered in the analysis were e.g. level and reason of amputation, age, weight, and height. During walking, oxygen consumption (ml O2/kg/min) and heart rate (beats/min) increased with a higher walking speed and a more proximal amputation. Additionally, oxygen consumption was determined by the interaction terms walking speed x amputation level and walking speed squared. Heart rate was determined by the interaction term walking speed squared.
During walking, oxygen consumption (ml O2/kg/min) and heart rate (beats/min) increased with a higher walking speed and a more proximal amputation. Data on metabolic costs of other activities were limited. The poor quality of the studies and the relatively healthy participants limited generalizability of the results of the meta-analysis.
系统回顾下肢截肢（LLA）患者日常生活活动（ADL）代谢成本的文献。
使用 LLA、代谢成本和 ADL 的关键词和同义词，在 Pubmed、Embase、CINAHL、CENTRAL 和 PsycINFO 数据库中进行文献检索。最后一次检索于 2017 年 11 月 29 日进行。
如果符合以下 2 个标准，则纳入研究：参与者为单侧或双侧 LLA 的成年人，并且在参与者进行体育活动或 ADL 时测量代谢成本。
系统评价和荟萃分析共纳入 61 项研究的 1912 名参与者。这些研究使用不同的术语来描述代谢成本。参与者是在不同的环境中招募的，相对健康，合并症较少。关于除使用假肢行走以外的其他活动的代谢成本，只有有限的数据。基于报告的平均值，采用线性混合模型分析，以研究为单位分析，不同组和测量条件的测试结果为单位分析内的重复测量。分析中输入的预测因子包括截肢水平和原因、年龄、体重和身高。在行走过程中，随着行走速度的增加和截肢位置的升高，耗氧量（ml O2/kg/min）和心率（次/分钟）增加。此外，耗氧量由行走速度 x 截肢水平和行走速度平方的交互项决定。心率由行走速度平方的交互项决定。
在行走过程中，随着行走速度的增加和截肢位置的升高，耗氧量（ml O2/kg/min）和心率（次/分钟）增加。关于其他活动代谢成本的数据有限。研究质量差，参与者相对健康，限制了荟萃分析结果的普遍性。
