Diment Laura, Nguon RaksmeyMutta, Seng Sovansereyrathna, Sit Vannsnavy, Lors Ply, Thor Phearsa, Srors Samedy, Kheng Sisary, Granat Malcolm, Donovan-Hall Maggie, Worsley Peter, Dickinson Alex
University of Southampton, Southampton, UK.
Department of Prosthetics and Orthotics, Phnom Penh, Cambodia.
J Neuroeng Rehabil. 2022 May 2;19(1):42. doi: 10.1186/s12984-022-01021-7.
After amputation, many people become less active, feel lonely and lose independence. Understanding the factors associated with low physical activity levels and participation could contribute to defining key interventions which can support prosthesis users so they can live a more active and socially included lifestyle. This longitudinal observational study aims to assess relationships between physical activity, community participation, prosthetic fit, comfort and user satisfaction using actimetry, 3D scans and questionnaires in a Cambodian cohort of established lower limb prosthesis users.
Twenty participants (5F:15M, nine transfemoral, eleven transtibial, 24-60 years old and 3-43 years since amputation) were recruited. They completed a questionnaire which included their demographics, community participation, prosthesis satisfaction and comfort at the start of the study, and between three and six months later. Their prosthetic sockets and residual limbs were 3D scanned at the start and end of the study. Accelerometers were embedded under the cosmesis on the shank of the prosthesis, to collect ten weeks of activity data.
Participants averaged 4470 steps/day (743-7315 steps/day), and wore their prosthesis for most waking hours, averaging 13.4 h/day (4.5-17.6 h/day). Self-reported measures of activity and hours of wear correlated with these accelerometer data (Spearman's rho r = 0.59, and r = 0.71, respectively). Participants who were more active wore their prosthesis for more hours/day (Pearson r = 0.73) and were more satisfied with socket fit (r = 0.49). A longer residual limb correlated with better community participation (r = 0.56) and comfort (r = 0.56). Self-reported community participation did not correlate with a person's activity level (r = 0.13), or their prosthesis comfort (r = 0.19), and there was only weak correlation between how important the activity was to an individual, and how often they participated in it (r = 0.37). A simple 0-10 scale of overall comfort did not provide enough detail to understand the types and severity of discomfort experienced.
Associations between perceived and measured activity levels correlated with socket satisfaction in this cohort of people with established lower limb amputations. The small sample size means these correlations should be interpreted with caution, but they indicate variables worthy of further study to understand barriers to community engagement and physical activity for prosthesis users in Cambodia, and potentially in other settings.
截肢后，许多人活动减少，感到孤独并失去独立性。了解与低身体活动水平及参与度相关的因素，有助于确定关键干预措施，以支持假肢使用者，使他们能够过上更积极且融入社会的生活方式。这项纵向观察性研究旨在通过活动测量法、三维扫描和问卷调查，评估柬埔寨一组下肢假肢使用者的身体活动、社区参与、假肢适配性、舒适度和用户满意度之间的关系。
招募了20名参与者（5名女性：15名男性，9名经股骨截肢，11名经胫骨截肢，年龄在24至60岁之间，截肢后3至43年）。他们在研究开始时以及三到六个月后完成了一份问卷，内容包括人口统计学信息、社区参与情况、假肢满意度和舒适度。在研究开始和结束时，对他们的假肢接受腔和残肢进行了三维扫描。加速度计被嵌入假肢小腿的美容罩下方，以收集十周的活动数据。
参与者平均每天步数为4470步（743 - 7315步/天），在大多数清醒时间佩戴假肢，平均每天佩戴13.4小时（4.5 - 17.6小时/天）。自我报告的活动量和佩戴时间与这些加速度计数据相关（斯皮尔曼相关系数分别为r = 0.59和r = 0.71）。活动量较大的参与者每天佩戴假肢的时间更长（皮尔逊相关系数r = 0.73），并且对接受腔适配性更满意（r = 0.49）。残肢较长与更好的社区参与度（r = 0.56）和舒适度（r = 0.56）相关。自我报告的社区参与度与个人的活动水平（r = 0.13）或假肢舒适度（r = 0.19）无关，而且活动对个人的重要程度与他们参与活动的频率之间仅有微弱的相关性（r = 0.37）。简单的0至10分总体舒适度评分无法提供足够详细的信息来了解所经历不适的类型和严重程度。
在这组已确定下肢截肢的人群中，感知到的和测量到的活动水平之间的关联与接受腔满意度相关。样本量较小意味着这些相关性应谨慎解读，但它们表明了一些变量值得进一步研究，以了解柬埔寨假肢使用者参与社区活动和进行身体活动的障碍，可能在其他环境中也适用。
