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影响非创伤性下肢截肢者日常生活活动、身体平衡及假肢适配的因素。

Factors affecting activities of daily living, physical balance, and prosthesis adjustment in non-traumatic lower limb amputees.

作者信息

Karaali Evren, Duramaz Altuğ, Çiloğlu Osman, Yalın Mustafa, Atay Mehmet, Aslantaş Furkan Çağlayan

机构信息

Department of Orthopeadics and Traumatology, Adana City Training and Research Hospital, Adana, Turkey.

Department of Orthopeadics and Traumatology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.

出版信息

Turk J Phys Med Rehabil. 2020 Oct 16;66(4):405-412. doi: 10.5606/tftrd.2020.4623. eCollection 2020 Dec.

Abstract

OBJECTIVES

This study aims to identify the factors affecting the activities of daily living, balance, and prosthesis satisfaction in patients with non-traumatic lower limb amputation (LLA).

PATIENTS AND METHODS

This cross-sectional study included a total of 195 patients (120 males, 75 females; mean age 65.9±11.6 years; range, 40 to 90 years) who underwent LLA between January 2009 and April 2017. All patients were evaluated in terms of age, sex, amputation etiology, side, level, comorbidity, length of hospital stay, prosthesis adjustment, ambulation level, functional outcome, and complications. Prosthesis adjustment, physical balance ability, and daily living activities were assessed using the Turkish versions of the Trinity Amputation and Prosthesis Experience Scales (TAPES), Berg Balance Scale (BBS), and Nottingham Extended Activities of Daily Living Scale (NEADLS), respectively.

RESULTS

There was no significant difference between male and female patients in terms of prosthesis and amputation adaptation, physical balance, and activities of daily living. The BBS, TAPES, and NEADLS scores were lower in the patients aged over 65 years (p<0.001, p<0.001, and p<0.001, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were also worse in this age group. Transfemoral amputees had lower BBS, TAPES, and NEADLS scores than the transtibial amputees (p=0.009, p=0.020, and p=0.004, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were worse in the transfemoral amputees.

CONCLUSION

Age and amputation level affect physical balance, prosthesis satisfaction, and daily living activities after non-traumatic LLA. Therefore, orthopedic surgeons and physical therapists should conduct a multidisciplinary evaluation, particularly in patients aged over 65 years and in transfemoral amputees to improve outcomes.

摘要

目的

本研究旨在确定影响非创伤性下肢截肢(LLA)患者日常生活活动、平衡能力及假肢满意度的因素。

患者与方法

本横断面研究共纳入195例患者(男性120例,女性75例;平均年龄65.9±11.6岁;范围40至90岁),这些患者于2009年1月至2017年4月期间接受了LLA手术。所有患者均在年龄、性别、截肢病因、部位、水平、合并症、住院时间、假肢调整、步行能力、功能结局及并发症等方面进行了评估。分别使用土耳其语版的三位一体截肢与假肢体验量表(TAPES)、伯格平衡量表(BBS)及诺丁汉扩展日常生活活动量表(NEADLS)对假肢调整、身体平衡能力及日常生活活动进行评估。

结果

在假肢与截肢适应、身体平衡及日常生活活动方面,男性和女性患者之间无显著差异。65岁以上患者的BBS、TAPES及NEADLS评分较低(分别为p<0.001、p<0.001及p<0.001)。该年龄组患者的假肢与截肢适应、身体平衡及日常生活活动情况也较差。经股截肢患者的BBS、TAPES及NEADLS评分低于经胫截肢患者(分别为p=0.009、p=0.020及p=为0.004)。经股截肢患者的假肢与截肢适应、身体平衡及日常生活活动情况较差。

结论

年龄和截肢水平影响非创伤性LLA术后的身体平衡、假肢满意度及日常生活活动。因此,骨科医生和物理治疗师应进行多学科评估,尤其是对于65岁以上患者及经股截肢患者,以改善治疗效果。

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