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在中低收入国家提供国际红十字会下肢假肢后的康复效果:来自缅甸的定量评估。

Efficacy of rehabilitation after provision of ICRC lower limb prostheses in low-income and middle-income countries: A quantitative assessment from Myanmar.

机构信息

Mandalay Orthopaedic Hospital, Prosthetics and Orthotics Department, Exceed Worldwide, Mandalay, Myanmar.

Centre for Medical Engineering and Technology, University of Dundee, Dundee, United Kingdom.

出版信息

Prosthet Orthot Int. 2024 Jan 1;48(1):5-12. doi: 10.1097/PXR.0000000000000300. Epub 2023 Oct 20.

Abstract

BACKGROUND

Low-income and middle-income countries (LMICs) have poorly resourced health services. Lack of access to assistive devices, such as prosthetics, may limit the functional outcomes of persons with amputation and affect quality of life (QoL).

OBJECTIVE

The objective of this study was to assess the functional level and QoL of prosthetic users in LMICs when prescribed a prosthesis made from International Committee for Red Cross (ICRC) components.

STUDY DESIGN

The study design included a quantitative descriptive methodology assessing functional outcomes and QoL after prosthetic provision.

METHODS

Participants were identified from the prosthetic service in Mandalay, Myanmar. Included participants were those with unilateral, traumatic, lower limb amputations, with ICRC devices delivered at least 6 months earlier. Participants attended the prosthetic service and were assessed using the Amputee Mobility Predictor with Prosthesis tool and the World Health Organization Quality of Life Brief and Disability modules.

RESULTS

Thirty-five participants completed the study; of them, 63% were persons with transtibial level amputation and 37% were with transfemoral level amputation. Approximately 83% achieved a score of more than 37 using the Amputee Mobility Predictor with Prosthesis. There is a strong positive correlation between QoL and physical health (r = 0.55; p < 0.001), social relationships (r = 0.66; p < 0.001), and inclusion (r = 0.53; p < 0.001). Participants had a better QoL and overall health when they had better psychological health.

CONCLUSION

The patient-based results presented within this study could be considered as a contribution to the evidence base and importance of provision of prosthetic services in LMICs. It was observed that participants with an amputation were able to achieve a high level of physical function with the ICRC prostheses while also reporting a high QoL.

摘要

背景

低收入和中等收入国家(LMICs)的医疗服务资源匮乏。由于缺乏假肢等辅助设备,截肢者的功能恢复可能受到限制,并影响生活质量(QoL)。

目的

本研究旨在评估在 LMICs 中,使用国际红十字委员会(ICRC)组件制成的假肢为患者提供假肢后的功能水平和生活质量。

研究设计

该研究设计包括一种定量描述方法,评估了假肢提供后的功能结果和生活质量。

方法

参与者是从缅甸曼德勒的假肢服务中确定的。纳入的参与者为单侧创伤性下肢截肢者,使用 ICRC 装置至少 6 个月。参与者参加了假肢服务,并使用假肢活动预测器与假肢工具和世界卫生组织生活质量简要和残疾模块进行评估。

结果

35 名参与者完成了研究;其中,63%的参与者为胫骨截肢者,37%的参与者为股骨截肢者。大约 83%的参与者使用假肢活动预测器与假肢的评分超过 37 分。生活质量与身体健康(r = 0.55;p < 0.001)、社会关系(r = 0.66;p < 0.001)和包容(r = 0.53;p < 0.001)呈强正相关。当参与者的心理健康状况更好时,他们的生活质量和整体健康状况也更好。

结论

本研究中的基于患者的结果可以被认为是对证据基础和在 LMICs 中提供假肢服务的重要性的贡献。研究观察到,截肢者使用 ICRC 假肢能够达到较高的身体功能水平,同时报告了较高的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ebe/10852039/8e727d83e900/poi-48-05-g001.jpg

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