Holden J M, Fernie G R
West Park Hospital, Department of Surgery, University of Toronto, Canada.
J Orthop Res. 1987;5(4):562-8. doi: 10.1002/jor.1100050411.
The extent of prosthesis use is reported for 104 lower limb amputees from the onset of gait training up to 2 years later. Subjects were divided into groups according to age (greater than or equal to 65 years or less than 65 years) and amputation level. An analysis of variance including the factors of age and level of amputation was done. Unilateral trans-tibial (UTT) amputees progressed more quickly during the inpatient gait training program that did unilateral trans-femoral (UTF) subjects (p less than 0.05). UTT subjects also walked more than UTF subjects just prior to discharge (p less than 0.05), during the first year after discharge (p less than 0.01), and during the second year after discharge (p less than 0.01). Similarly, younger patients progressed more quickly in gait training (p less than 0.05) and walked more than older subjects throughout the study period (p less than 0.05). There were no significant interactions between age and amputation. The extent of walking of these amputees is compared with the minimal levels required for them to function in different living environments. At the time of discharge from the inpatient gait training program, older unilateral amputees and trans-femoral amputees were not able to walk the 600 steps a day necessary to manage with a moderate level of support in a one-level apartment or home. The declining number of steps taken in the follow-up period indicated that the UTF subjects might benefit from some special attention paid to their community support needs. These findings are also viewed in the context of limited data available on the extent of walking of non-amputees.
报告了104名下肢截肢者从步态训练开始到两年后的假肢使用情况。受试者根据年龄(大于或等于65岁或小于65岁)和截肢水平分组。进行了一项包含年龄和截肢水平因素的方差分析。在住院步态训练项目中,单侧胫骨截肢(UTT)患者比单侧股骨截肢(UTF)患者进展更快(p<0.05)。UTT患者在出院前(p<0.05)、出院后第一年(p<0.01)和出院后第二年(p<0.01)行走的步数也比UTF患者多。同样,年轻患者在步态训练中进展更快(p<0.05),并且在整个研究期间行走的步数比老年受试者多(p<0.05)。年龄和截肢之间没有显著的交互作用。将这些截肢者的行走程度与他们在不同生活环境中发挥功能所需的最低水平进行了比较。在住院步态训练项目出院时,老年单侧截肢者和股骨截肢者无法达到在单层公寓或家中获得适度支持所需的每天600步的行走量。随访期间步数的减少表明,UTF患者可能会受益于对其社区支持需求给予的一些特别关注。这些发现也是在非截肢者行走程度的可用数据有限的背景下进行考量的。