Atalay Kardelen Gencer, Keniş Coşkun Özge, Giray Esra, Gündüz Osman Hakan, Yağcı İlker
Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Türkiye.
Turk J Phys Med Rehabil. 2022 Jun 1;68(2):222-230. doi: 10.5606/tftrd.2022.7655. eCollection 2022 Jun.
This study aims to investigate cross-sectional area of the amputated-limb rectus femoris compared to the intact-limb and controls and to determine its correlation with functional strength and walking tests in prosthesis users with transtibial amputation.
Between October 2018 and April 2019, a total of 14 prosthesis users (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) who met the inclusion criteria, and 14 age-, sex-, and dominancy-matched able-bodied controls (12 males, 2 females; mean age: 47.1±16.2 years; range, 26 to 73 years) were included in this case-control study. Cross-sectional area of rectus femoris (CSA-RF) was evaluated bilaterally by two independent examiners. Knee extension strength was measured bilaterally by using a handheld dynamometer. Functional strength and walking were assessed by Step-Up-Over and Walk-Across tests of the NeuroCom Balance Master® device.
The CSA-RF was found to be reduced in amputated-limb compared to the intact-limb and able-bodied controls (p<0.01). In the prosthesis users, the cross-sectional area difference between both limbs rectus femoris muscles was shown to be correlated with actual and functional knee extension strength, step length, and walking speed (p<0.05). Intra- and inter-observer reliability of CSA-RF on both sides were found to be good to excellent (intraclass correlation coefficient: 0.856-0.936).
Ultrasonographic measurement of CSA-RF is a valid and reliable tool to assess the functional strength and walking in the prosthesis users with unilateral transtibial amputation.
本研究旨在调查截肢侧股直肌的横截面积，并与健侧肢体及对照组进行比较，同时确定其与经胫截肢假体使用者功能强度和步行测试之间的相关性。
2018年10月至2019年4月，共有14名符合纳入标准的假体使用者（12名男性，2名女性；平均年龄：47.1±16.2岁；范围26至73岁）和14名年龄、性别及优势侧匹配的健全对照者（12名男性，2名女性；平均年龄：47.1±16.2岁；范围26至73岁）纳入本病例对照研究。两名独立检查者对双侧股直肌横截面积（CSA-RF）进行评估。使用手持测力计双侧测量膝关节伸展力量。通过NeuroCom Balance Master®设备的上台阶和横穿测试评估功能强度和步行能力。
与健侧肢体和健全对照者相比，截肢侧的CSA-RF减小（p<0.01）。在假体使用者中，双侧股直肌肌肉的横截面积差异与实际和功能性膝关节伸展力量、步长及步行速度相关（p<0.05）。发现双侧CSA-RF的观察者内和观察者间可靠性良好至优秀（组内相关系数：0.856 - 0.936）。
超声测量CSA-RF是评估单侧经胫截肢假体使用者功能强度和步行能力的有效且可靠工具。
