Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Ordination Dr. Kelaridis and Partner, Vienna, Austria.
Orthop Traumatol Surg Res. 2022 Jun;108(4):103229. doi: 10.1016/j.otsr.2022.103229. Epub 2022 Feb 2.
It is well-known that exercise through sports and physical activity has beneficial effects on health. After lower extremity amputation, low rates of participation in sports activities have been shown. So far, there is only limited scientific long-term information concerning sports activity and feasible types of sports in patients with lower extremity amputations due to malignant tumors. This study sought to provide very long-term information about the following questions: (1) What sports activity levels can be achieved after lower extremity amputation due to a malignant tumor? (2) What are feasible types of sports? (3) Is the University of California Los Angeles (UCLA) Activity Score influenced by patient's age, the age at the time of surgery and the amount of prosthesis sockets used to date?
Patients with lower extremity amputation due to a malignant tumor cannot regularly participate in moderate sports activities (UCLA Activity Score≥6) in the very long-term.
In a retrospective questionnaire survey, 21 former patients (seven females, 14 males; median age: 60.5years [range: 33-74]) who underwent an amputation of the lower extremity (14 transfemoral, four knee disarticulations, three transtibial) from 1961 to 1993 due to a malignant tumor were interviewed. The median follow-up was 41.1years (range: 23-55). The patients were interviewed about types of sports, frequencies and durations of sports sessions at the time of the last follow-up, as well as retrospectively. Sports activity levels were then assessed based on the UCLA Activity Score. Demographic background, data on amputation level, histological results, prosthetic devices and revision surgeries were collected.
Seven patients (33%) were still regularly exercising at least moderate sports activities at the last follow-up, including one patient regularly participating in impact sports. The preoperative median UCLA Activity Score of 9 (range: 2-10) decreased to 5 (range: 2-10) at the last follow-up (p<0.001). Swimming (13 patients, seven on a regular basis), cycling (seven), downhill skiing (five) and hiking (four) were among the most common feasible types of sports. Increasing age had a negative influence on the UCLA Activity Score [95% CI (-0.034, -0.006); R=-0.020; SD=0.0074; p=0.007].
After a major amputation in the lower extremity due to a malignant tumor, high activity levels by practicing types of sports such as downhill skiing, are achievable. In the very long-term, a regular participation in at least moderate activities, such as swimming, is possible. Programs for physical and sports activities, based on recommendations drawn from long-term experience, are necessary and should be individually tailored to amputees and their limitations.
IV.
众所周知，运动和体育活动对健康有益。下肢截肢后，参与体育活动的比例较低。迄今为止，由于恶性肿瘤而接受下肢截肢的患者的体育活动和可行的运动类型的科学长期信息有限。本研究旨在提供有关以下问题的非常长期信息：（1）由于恶性肿瘤导致下肢截肢后，可以达到什么运动水平？（2）可行的运动类型有哪些？（3）加利福尼亚大学洛杉矶分校（UCLA）活动评分是否受患者年龄、手术时的年龄以及迄今为止使用的假肢套数量的影响？
由于恶性肿瘤而接受下肢截肢的患者在非常长期内无法定期进行中等强度的体育活动（UCLA 活动评分≥6）。
在回顾性问卷调查中，我们采访了 21 名曾于 1961 年至 1993 年因恶性肿瘤接受下肢截肢（14 例股骨截肢，4 例膝关节离断，3 例胫骨截肢）的患者（7 名女性，14 名男性；中位年龄：60.5 岁[范围：33-74]）。中位随访时间为 41.1 年（范围：23-55）。患者在最后一次随访时以及回顾性地接受了关于运动类型、运动次数和持续时间的采访。然后根据 UCLA 活动评分评估运动水平。收集了人口统计学背景、截肢水平、组织学结果、假肢设备和翻修手术的数据。
7 名患者（33%）在最后一次随访时仍定期进行至少中等强度的体育活动，包括 1 名定期参加撞击运动的患者。术前中位数 UCLA 活动评分为 9（范围：2-10），最后一次随访时降至 5（范围：2-10）（p<0.001）。游泳（13 名患者，7 名定期游泳）、骑自行车（7 名）、下坡滑雪（5 名）和徒步旅行（4 名）是最常见的可行运动类型之一。年龄增长对 UCLA 活动评分有负面影响[95%置信区间（-0.034，-0.006）；R=-0.020；SD=0.0074；p=0.007]。
由于恶性肿瘤导致下肢截肢后，可进行高强度的运动，如下坡滑雪。在非常长期内，游泳等至少中等强度的活动是可以定期参与的。基于长期经验得出的建议，制定身体和体育活动计划是必要的，并且应根据截肢者及其局限性进行个性化定制。
IV。
