Essop-Adam Amirah, Daynes Enya, Houghton John S M, Nickinson Andrew T O, Sayers Robert D S, Haunton Victoria J, Pepper Coral, Singh Sally J
Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, United Kingdom; National Institute for Health Research Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom.
National Institute for Health Research Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom; Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Sciences, University of Leicester, Groby Road, Leicester, LE3 9QP, United Kingdom.
Ann Phys Rehabil Med. 2023 Sep;66(6):101756. doi: 10.1016/j.rehab.2023.101756. Epub 2023 Jun 3.
Objective physical performance-based outcome measures (PerBOMs) are essential tools for the holistic management of people who have had an amputation due to vascular disease. These people are often non-ambulatory, however it is currently unclear which PerBOMs are high quality and appropriate for those who are either ambulatory or non-ambulatory.
Which PerBOMs have appropriate clinimetric properties to be recommended for those who have had amputations due to vascular disease ('vascular amputee')?
MEDLINE, CINAHL, EMBASE, EMCARE, the Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus databases were searched for the terms: "physical performance" or "function", "clinimetric properties", "reliability", "validity", "amputee" and "peripheral vascular disease" or "diabetes".
A systematic review of PerBOMs for vascular amputees was performed following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and PRISMA guidelines. The quality of studies and individual PerBOMs was assessed using COSMIN risk of bias and good measurement properties. Overall PerBOM quality was evaluated with a modified GRADE rating. Key clinimetric properties evaluated were reliability, validity, predictive validity and responsiveness.
A total of 15,259 records were screened. Forty-eight studies (2650 participants) were included: 7 exclusively included vascular amputees only, 35 investigated validity, 20 studied predictive validity, 23 investigated reliability or internal consistency and 7 assessed responsiveness. Meta-analysis was neither possible nor appropriate for this systematic review in accordance with COSMIN guidelines, due to heterogeneity of the data. Thirty-four different PerBOMs were identified of which only 4 are suitable for non-ambulatory vascular amputees. The Amputee Mobility Predictor no Prosthesis (AMPnoPro) and Transfemoral Fitting Predictor (TFP) predict prosthesis use only. PerBOMs available for assessing physical performance are the One-Leg Balance Test (OLBT) and Basic Amputee Mobility Score (BAMS).
At present, few PerBOMs can be recommended for vascular amputees. Only 4 are available for non-ambulatory individuals: AMPnoPro, TFP, OLBT and BAMS.
基于客观身体表现的结局指标（PerBOMs）是对因血管疾病而截肢者进行整体管理的重要工具。这些人通常无法行走，然而目前尚不清楚哪些PerBOMs对于能行走或不能行走的人而言是高质量且合适的。
哪些PerBOMs具有适当的测量学特性，可推荐给因血管疾病而截肢的人（“血管性截肢者”）？
在MEDLINE、CINAHL、EMBASE、EMCARE、Cochrane图书馆、Cochrane对照试验中央注册库（CENTRAL）和Scopus数据库中搜索以下术语：“身体表现”或“功能”、“测量学特性”、“可靠性”、“有效性”、“截肢者”以及“外周血管疾病”或“糖尿病”。
按照基于共识的健康测量工具选择标准（COSMIN）方法和PRISMA指南，对血管性截肢者的PerBOMs进行系统综述。使用COSMIN偏倚风险和良好测量特性评估研究及各个PerBOMs的质量。采用改良的GRADE分级评估总体PerBOM质量。评估的关键测量学特性包括可靠性、有效性、预测有效性和反应性。
共筛选出15259条记录。纳入48项研究（2650名参与者）：7项仅纳入血管性截肢者，35项研究有效性，20项研究预测有效性，23项研究可靠性或内部一致性，7项评估反应性。根据COSMIN指南，由于数据的异质性，本系统综述既无法也不适合进行荟萃分析。确定了34种不同的PerBOMs，其中只有4种适用于不能行走的血管性截肢者。截肢者无假肢移动预测器（AMPnoPro）和经股骨适配预测器（TFP）仅预测假肢使用情况。可用于评估身体表现的PerBOMs是单腿平衡测试（OLBT）和基本截肢者移动评分（BAMS）。
目前，几乎没有PerBOMs可推荐给血管性截肢者。只有4种适用于不能行走的个体：AMPnoPro、TFP、OLBT和BAMS。
