Poonsiri Jutamanee, Dekker Rienk, Dijkstra Pieter U, Hijmans Juha M, Geertzen Jan H B
Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
BMC Sports Sci Med Rehabil. 2021 Jul 10;13(1):75. doi: 10.1186/s13102-021-00302-3.
To evaluate cycling participation and identify barriers and facilitators related to cycling participation in people with a lower limb amputation (LLA) in the Netherlands.
A questionnaire was sent to adults with a LLA between March and August 2019 to obtain information regarding prosthesis, individual's characteristics, amputation, cycling barriers and facilitators, and prosthetic satisfaction. The questionnaires were distributed via 8 orthopedic workshops, post and were given directly. To find cycling predictors, variables associated with cycling (p < 0.1) were entered into a logistic regression analysis. Non-significant variables were removed manually.
Participants (n = 207, 71% males) had a mean age of 62.0 ± 13.0 years. The most frequent level of amputation was transtibial (42%), and trauma was the most frequent cause of amputation (43%). After the LLA, 141 participants (68%) cycled for recreation (80%), physical fitness (74%), and transport (50%). In the past six months, cyclists cycled for recreation (79%) and transport (66%). Most cycled less than once a day. Recreational cyclists cycled alone (75%) for a median duration of 45 min or 14 km per ride. Cyclists with a transportation purpose usually cycled to go shopping (80%) or to visit friends (68%), with a median duration of 20 min or five kilometers per ride. Cyclists reported more facilitators (median (IQR) = 5 (3, 7) than non-cyclists 0 (0, 3). The majority of cyclists reported a positive attitude toward cycling (89%) and cycled because of health benefits (81%). A dynamic foot (odds ratio: 5.2, 95% CI 2.0, 13.3) and a higher number of facilitators (odds ratio: 1.3, 95% CI 1.2, 1.5) positively predicted cycling, whereas the presence of other underlying diseases (odds ratio: 0.4, 95% CI 0.2, 0.9) negatively predicted cycling (R: 40.2%).
In the Netherlands, the majority of adults cycled after a LLA, mainly for recreational purposes. A dynamic foot, a higher number of facilitators, and no other underlying diseases increases the likelihood of cycling after a LLA. The results suggest that personal motivation and a higher mobility level could be the key to increasing cycling participation. Future research should determine the association between motivation, mobility levels, and cycling with a LLA.
评估荷兰下肢截肢（LLA）患者的骑行参与情况，并确定与骑行参与相关的障碍和促进因素。
于2019年3月至8月向成年LLA患者发放问卷，以获取有关假肢、个人特征、截肢情况、骑行障碍和促进因素以及假肢满意度的信息。问卷通过8个骨科诊所、邮寄以及直接发放的方式进行分发。为了找出骑行的预测因素，将与骑行相关（p < 0.1）的变量纳入逻辑回归分析。手动去除无显著意义的变量。
参与者（n = 207，71%为男性）的平均年龄为62.0 ± 13.0岁。最常见的截肢部位是胫骨（42%），创伤是最常见的截肢原因（43%）。LLA后，141名参与者（68%）为了娱乐（80%）、健身（74%）和交通（50%）而骑行。在过去六个月中，骑行者为了娱乐（79%）和交通（66%）而骑行。大多数人每天骑行少于一次。娱乐骑行者独自骑行（75%），每次骑行的中位时长为45分钟或14公里。以交通为目的的骑行者通常骑车去购物（80%）或拜访朋友（68%），每次骑行的中位时长为20分钟或5公里。骑行者报告的促进因素（中位数（四分位间距）= 5（3，7））多于非骑行者（0（0，3））。大多数骑行者对骑行持积极态度（89%），并且因为对健康有益而骑行（81%）。动态足部（优势比：5.2，95%置信区间2.0，13.3）和更多的促进因素（优势比：1.3，95%置信区间1.2，1.5）对骑行有积极预测作用，而存在其他基础疾病（优势比：0.4，95%置信区间0.2，0.9）对骑行有消极预测作用（R：40.2%）。
在荷兰，大多数成年LLA患者在截肢后会骑行，主要是为了娱乐。动态足部、更多的促进因素以及不存在其他基础疾病会增加LLA后骑行的可能性。结果表明个人动机和更高的活动能力可能是增加骑行参与度的关键。未来的研究应确定动机、活动能力水平与LLA后骑行之间的关联。
