Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, FL, USA.
The Australian School of Advanced Medicine, Macquarie University, North Ryde, Australia.
Prosthet Orthot Int. 2023 Apr 1;47(2):130-136. doi: 10.1097/PXR.0000000000000189. Epub 2022 Dec 28.
The literature comparing bone-anchored prosthesis (BAP) with socket prosthesis (SP) consistently reports improvement in physical health and quality of life using primarily patient-reported outcome measures (PROMs).
To determine the differences in mobility and balance using performance-based outcome measures and PROMs in people with transfemoral amputations (TFAs) fitted with BAP vs. SP.
Causal comparative.
Two groups of people with TFAs were recruited: one using a BAP (N = 11; mean age ± standard deviation, 44 ± 14.9 years; mean residual limb length as a percentage of the intact femur, 68% ± 15.9) and another group using a SP (N = 11; mean age ± standard deviation, 49.6 ± 16.0 years; mean residual limb length as a percentage of the intact femur, 81% ± 13.9), and completed the 10-meter walk test, component timed-up-and-go, Prosthetic Limb Users Survey of Mobility™ 12-item, and Activities-specific Balance Confidence Scale.
There were no statistically significant differences between the BAP and SP groups in temporal spatial gait parameters and prosthetic mobility as measured by the 10-meter walk test and component timed-up-and-go, yet large effect sizes were found for several variables. In addition, Activities-specific Balance Confidence Scale and Prosthetic Limb Users Survey of Mobility™ scores were not statistically different between the BAP and SP groups, yet a large effect sizes were found for both variables.
This study found that people with TFA who use a BAP can demonstrate similar temporal spatial gait parameters and prosthetic mobility, as well as self-perceived balance confidence and prosthetic mobility as SP users. Therefore, suggesting that the osseointegration reconstruction surgical procedure provides an alternative option for a specific population with TFA who cannot wear nor have limitations with a SP. Future research with a larger sample and other performance-based outcome measures and PROMs of prosthetic mobility and balance would further determine the differences between the prosthetic options.
比较骨锚式假体（BAP）和插座假体（SP）的文献一致报告，使用主要的患者报告结局测量（PROM），在接受股骨截肢（TFA）的患者中，在身体健康和生活质量方面有所改善。
使用基于表现的结局测量和 PROM 来确定使用 BAP 与 SP 装配的 TFA 患者在移动性和平衡方面的差异。
因果比较。
招募了两组 TFA 患者：一组使用 BAP（N=11；平均年龄±标准差，44±14.9 岁；残肢长度占完整股骨的百分比，68%±15.9），另一组使用 SP（N=11；平均年龄±标准差，49.6±16.0 岁；残肢长度占完整股骨的百分比，81%±13.9），并完成了 10 米步行测试、组件计时起立行走测试、假肢使用者移动性调查 12 项和活动特定平衡信心量表。
在 10 米步行测试和组件计时起立行走测试中，BAP 和 SP 组之间的时间空间步态参数和假肢移动性没有统计学上的显著差异，但几个变量的效应量较大。此外，BAP 和 SP 组之间的活动特定平衡信心量表和假肢使用者移动性调查得分没有统计学上的差异，但两个变量的效应量都较大。
本研究发现，使用 BAP 的 TFA 患者可以表现出类似的时间空间步态参数和假肢移动性，以及自我感知的平衡信心和 SP 用户的假肢移动性。因此，这表明骨整合重建手术为不能佩戴或有 SP 限制的特定 TFA 患者提供了一种替代选择。未来使用更大样本量和其他假肢移动性和平衡的基于表现的结局测量和 PROM 的研究将进一步确定假肢选择之间的差异。
