部分足部截肢水平与步态之间的关联：一项对轮椅网球最低损伤标准有影响的范围综述。

Association between the level of partial foot amputation and gait: a scoping review with implications for the minimum impairment criteria for wheelchair tennis.

作者信息

de Oliveira Fábio Carlos Lucas, Williamson Samuel, Ardern Clare L, Fagher Kristina, Heron Neil, Janse van Rensburg Dina Christina Christa, Jansen Marleen G T, Kolman Nikki, O'Connor Sean Richard, Saueressig Tobias, Schoonmade Linda, Thornton Jane S, Webborn Nick, Pluim Babette M

机构信息

Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada

Research Unit in Sport and Physical Activity (CIDAF), University of Coimbra, Coimbra, Portugal.

出版信息

Br J Sports Med. 2022 Dec 5. doi: 10.1136/bjsports-2022-105650.

DOI:10.1136/bjsports-2022-105650

PMID:36588404

Abstract

OBJECTIVE

This scoping review examines how different levels and types of partial foot amputation affect gait and explores how these findings may affect the minimal impairment criteria for wheelchair tennis.

METHODS

Four databases (PubMed, Embase, CINAHL and SPORTDiscus) were systematically searched in February 2021 for terms related to partial foot amputation and ambulation. The search was updated in February 2022. All study designs investigating gait-related outcomes in individuals with partial foot amputation were included and independently screened by two reviewers based on Arksey and O'Malley's methodological framework and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews.

RESULTS

Twenty-nine publications with data from 252 participants with partial foot amputation in 25 studies were analysed. Toe amputations were associated with minor gait abnormalities, and great toe amputations caused loss of push-off in a forward and lateral direction. Metatarsophalangeal amputations were associated with loss of stability and decreased gait speed. Ray amputations were associated with decreased gait speed and reduced lower extremity range of motion. Transmetatarsal amputations and more proximal amputations were associated with abnormal gait, substantial loss of power generation across the ankle and impaired mobility.

CONCLUSIONS

Partial foot amputation was associated with various gait changes, depending on the type of amputation. Different levels and types of foot amputation are likely to affect tennis performance. We recommend including first ray, transmetatarsal, Chopart and Lisfranc amputations in the minimum impairment criteria, excluding toe amputations (digits two to five), and we are unsure whether to include or exclude great toe, ray (two to five) and metatarsophalangeal amputations.

TRIAL REGISTRATION

The protocol of this scoping review was previously registered at the Open Science Framework Registry (https://osf.io/8gh9y) and published.

摘要

目的

本范围综述探讨不同程度和类型的足部部分截肢如何影响步态，并探究这些结果可能如何影响轮椅网球的最低损伤标准。

方法

2021年2月，系统检索了四个数据库（PubMed、Embase、CINAHL和SPORTDiscus）中与足部部分截肢和行走相关的术语。2022年2月更新了检索。纳入了所有调查足部部分截肢个体步态相关结果的研究设计，并由两名评审员根据阿克斯和奥马利的方法框架进行独立筛选，并根据系统评价和Meta分析的首选报告项目扩展版进行范围综述报告。

结果

分析了29篇出版物，这些出版物来自25项研究中的252名足部部分截肢参与者的数据。趾截肢与轻微步态异常相关，而拇趾截肢导致向前和侧向蹬离能力丧失。跖趾关节截肢与稳定性丧失和步态速度降低相关。射线截肢与步态速度降低和下肢活动范围减小相关。经跖骨截肢和更高水平的截肢与异常步态、踝关节动力产生大量丧失和活动能力受损相关。