Division of Physical Therapy, 1371Emory University School of Medicine, Atlanta, GA, USA.
School of Biological Sciences, 1372Georgia Tech, Atlanta, GA, USA.
Neurorehabil Neural Repair. 2022 Mar;36(3):208-216. doi: 10.1177/15459683211070277. Epub 2021 Dec 30.
Most of the current literature around amputation focuses on lower extremity amputation or engineering aspects of prosthetic devices. There is a need to more clearly understand neurobehavioral mechanisms related to upper extremity amputation and how such mechanisms might influence recovery and utilization of prostheses.
This scoping review aims to identify and summarize the current literature on adult traumatic upper limb amputation in regard to recovery and functional outcomes and how neuroplasticity might influence these findings.
We identified appropriate articles using Academic Search Complete EBSCO, OVID Medline, and Cochrane databases. The resulting articles were then exported, screened, and reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines.
Eleven (11) studies met the study criteria. Of these studies, 7 focused on sensory involvement, 3 focused on neuroplastic changes post-amputation related to functional impact, and 1 study focused on motor control and learning post-amputation. Overall, these studies revealed an incomplete understanding of the neural mechanisms involved in motor rehabilitation in the central and peripheral nervous systems, while also demonstrating the value of an individualized approach to neurorehabilitation in upper limb loss.
There is a gap in our understanding of the role of neurorehabilitation following amputation. Overall, focused rehabilitation parameters, demographic information, and clarity around central and peripheral neural mechanisms are needed in future research to address neurobehavioral mechanisms to promote functional recovery following traumatic upper extremity amputation.
目前大多数关于截肢的文献都集中在下肢截肢或假肢工程方面。需要更清楚地了解与上肢截肢相关的神经行为机制，以及这些机制如何影响假肢的康复和使用。
本范围综述旨在确定和总结有关成人外伤性上肢截肢的现有文献，重点关注康复和功能结果，以及神经可塑性如何影响这些发现。
我们使用 Academic Search Complete EBSCO、OVID Medline 和 Cochrane 数据库来识别和筛选合适的文章。然后，根据系统评价和荟萃分析的首选报告项目（PRISMA-ScR）指南，导出、筛选和审查这些文章。
有 11 项研究符合研究标准。其中 7 项研究关注感觉参与，3 项研究关注与功能影响相关的截肢后神经可塑性变化，1 项研究关注截肢后运动控制和学习。总体而言，这些研究揭示了我们对中枢和外周神经系统中运动康复所涉及的神经机制的理解不完整，同时也证明了针对上肢丧失的个体化神经康复方法的价值。
我们对截肢后神经康复的作用理解存在差距。总体而言，未来的研究需要重点关注康复参数、人口统计学信息以及中枢和外周神经机制的清晰度，以解决神经行为机制问题，促进外伤性上肢截肢后的功能康复。
