下肢截肢者膝关节骨关节炎和下腰痛的生物力学危险因素：系统评价方案。
Biomechanical risk factors for knee osteoarthritis and lower back pain in lower limb amputees: protocol for a systematic review.
机构信息
Department for Health, University of Bath, Bath, UK
Department for Health, University of Bath, Bath, UK.
出版信息
BMJ Open. 2022 Nov 21;12(11):e066959. doi: 10.1136/bmjopen-2022-066959.
INTRODUCTION
There is a limited research exploring biomechanical risk factors for the development of knee osteoarthritis (KOA) and lower back pain (LBP) between lower limb amputee subgroups, (eg, transtibial amputees (TTA) vs transfemoral amputees (TFA), or TTA dysvascular vs TTA traumatic). Previous reviews have focused primarily on studies where symptoms of KOA or LBP are present, however, due to limited study numbers, this hinders their scope and ability to compare between amputee subgroups. Therefore, the aim of this systematic review is to descriptively compare biomechanical risk factors for developing KOA and LBP between lower limb amputee subgroups, irrespective of whether KOA or LBP was present.
METHODS AND ANALYSIS
This review is currently in progress and screening results are presented alongside the protocol to highlight challenges encountered during data extraction. Five electronic databases were searched (Medline-Web of Science, PubMed, CINAHL, Embase and Scopus). Eligible studies were observational or interventional, reporting biomechanical gait outcomes for individual legs in adult lower limb amputees during flat walking, incline/decline walking or stair ascent/descent. Two reviewers screened for eligibility and level of agreement was assessed using Cohen's Kappa. Data extraction is ongoing. Risk of bias will be assessed using a modified Downs and Black method, and outcome measures will be descriptively synthesised.
ETHICS AND DISSEMINATION
There are no ethical considerations for this systematic review. Due to its scope, results are expected to be published in three separate manuscripts: (1) biomechanical risk factors of KOA between TTA and TFA, relative to non-amputees, (2) biomechanical risk factors of LBP between TTA and TFA, relative to non-amputees and (3) biomechanical risk factors of KOA and LBP between TTA with traumatic or dysvascular causes, relative to non-amputees.
PROSPERO REGISTRATION NUMBER
CRD42020158247.
简介
对于下肢截肢亚组（例如，胫骨截肢（TTA）与股骨截肢（TFA），或 TTA 血管性与 TTA 创伤性）之间膝骨关节炎（KOA）和下腰痛（LBP）的生物力学危险因素，研究有限。 之前的综述主要集中在存在 KOA 或 LBP 症状的研究上，但是，由于研究数量有限，这限制了它们的范围和比较截肢亚组之间的能力。 因此，本系统综述的目的是描述性地比较下肢截肢亚组中 KOA 和 LBP 的生物力学危险因素，而不论是否存在 KOA 或 LBP。
方法和分析
本综述正在进行中，筛选结果与方案一起呈现，以突出数据提取过程中遇到的挑战。 五个电子数据库（Medline-Web of Science、PubMed、CINAHL、Embase 和 Scopus）进行了搜索。 合格的研究是观察性或干预性的，报告了成人下肢截肢者在平地上行走、倾斜/下降行走或上下楼梯时单个腿部的生物力学步态结果。 两名审查员筛选合格性，并用 Cohen's Kappa 评估一致性程度。 数据提取正在进行中。 使用改良的 Downs 和 Black 方法评估偏倚风险，描述性综合评估结果测量。
伦理和传播
本系统综述无伦理考虑。 由于其范围，预计结果将发表在三篇单独的论文中：（1）TTA 和 TFA 与非截肢者相比，KOA 的生物力学危险因素，（2）TTA 和 TFA 与非截肢者相比，LBP 的生物力学危险因素，以及（3）TTA 创伤性或血管性病因与非截肢者相比，KOA 和 LBP 的生物力学危险因素。
PROSPERO 注册号：CRD42020158247。
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