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评估下肢假肢适配性的方法:一项系统综述

Methods to assess lower limb prosthetic adaptation: a systematic review.

作者信息

Olaya-Mira Natali, Gómez-Hernández Luz Marina, Viloria-Barragán Carolina, Soto-Cardona Isabel Cristina

机构信息

Grupo de Investigación e Innovación Biomédica, Instituto Tecnológico Metropolitano, Medellin, Colombia.

Laboratorio de Biomecánica y Rehabilitación, Instituto Tecnológico Metropolitano, Medellín, Colombia.

出版信息

J Neuroeng Rehabil. 2025 Apr 29;22(1):100. doi: 10.1186/s12984-024-01530-7.

DOI:10.1186/s12984-024-01530-7
PMID:40301975
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12042526/
Abstract

BACKGROUND

Lower limb amputation is a disabling condition with serious psychological, physical, and functional consequences. The adaptation of a prosthetic device can either mitigate or exacerbate these effects. Although many individuals receive lower limb prostheses, rejection rates remain high. Furthermore, while numerous objective and quantitative methods are available to assess the interface between the residual limb and the prosthetic socket, as well as the device performance, prosthetic fitting largely relies on prosthetists' observation and expertise. Accordingly, this review describes the most commonly employed methods for evaluating prosthetic fitting, emphasizing frequently used combinations of tools, devices, procedures, and tests for characterizing residual limbs and clinical outcomes, which indirectly contribute to prosthetic fitting evaluation.

MAIN BODY

In July 2023, searches were conducted across the Taylor & Francis, SpringerLink, Sage, ScienceDirect, and Scopus databases, focusing on research papers, case reports, and technical briefs published between 2011 and 2023. Studies were selected by four reviewers, and any discrepancies were resolved through group discussions. The Rayyan tool was employed to ensure that the retrieved publications evaluated residual limb variables involved in prosthetic fitting. The predominant methods for assessing lower-limb prosthetic fitting include mobility evaluation, gait analysis, measurement of physical variables, and stability assessment. Functional tests and self-report questionnaires, which do not require specialized equipment or great expertise, are the most widely utilized techniques.

CONCLUSIONS

The results demonstrate that, within clinical practice, mobility evaluation is the primary predictor of prosthetic fitting. Since methodologies for measuring more specific variables are often restricted to laboratory settings, future studies should analyze factors that could enable their implementation in clinical contexts.

摘要

背景

下肢截肢是一种致残性疾病,会带来严重的心理、身体和功能后果。假肢装置的适配情况可能减轻或加重这些影响。尽管许多人接受了下肢假肢,但排斥率仍然很高。此外,虽然有许多客观和定量的方法可用于评估残肢与假肢接受腔之间的界面以及装置性能,但假肢适配在很大程度上仍依赖于假肢矫形师的观察和专业知识。因此,本综述描述了评估假肢适配最常用的方法,重点介绍了用于表征残肢和临床结果的工具、装置、程序和测试的常用组合,这些间接有助于假肢适配评估。

正文

2023年7月,在泰勒与弗朗西斯、施普林格Link、Sage、科学Direct和Scopus数据库中进行了检索,重点关注2011年至2023年发表的研究论文、病例报告和技术简报。由四位评审员挑选研究,任何分歧都通过小组讨论解决。使用Rayyan工具确保检索到的出版物评估了假肢适配中涉及的残肢变量。评估下肢假肢适配的主要方法包括活动能力评估、步态分析、身体变量测量和稳定性评估。功能测试和自我报告问卷不需要专门设备或很高的专业知识,是使用最广泛的技术。

结论

结果表明,在临床实践中,活动能力评估是假肢适配的主要预测指标。由于测量更具体变量的方法通常仅限于实验室环境,未来的研究应分析能够使其在临床环境中得以应用的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/75414a4b2339/12984_2024_1530_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/2df6fbdfe5e6/12984_2024_1530_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/7b9104ffd5ac/12984_2024_1530_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/5c5b9b212c86/12984_2024_1530_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/75414a4b2339/12984_2024_1530_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/2df6fbdfe5e6/12984_2024_1530_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/7b9104ffd5ac/12984_2024_1530_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/5c5b9b212c86/12984_2024_1530_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c63b/12042526/75414a4b2339/12984_2024_1530_Fig4_HTML.jpg

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本文引用的文献

1
Next-generation devices to diagnose residuum health of individuals suffering from limb loss: A narrative review of trends, opportunities, and challenges.用于诊断肢体缺失患者残留健康状况的下一代设备:趋势、机遇和挑战的叙述性综述。
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A proper sequence of dynamic alignment in transtibial prosthesis: insight through socket reaction moments.适当的动平衡序列在小腿假肢中:通过接受腔反作用力矩的观察。
Sci Rep. 2023 Jan 10;13(1):458. doi: 10.1038/s41598-023-27438-1.
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A Modified Version of the Forgotten Joint Score-12 in Lower Limb Amputees: Validity and Reliability Study.
下肢截肢者遗忘关节评分-12的改良版本:效度与信度研究
OTJR (Thorofare N J). 2023 Apr;43(2):288-295. doi: 10.1177/15394492221123521. Epub 2022 Sep 20.
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Activity, socket fit, comfort and community participation in lower limb prosthesis users: a Cambodian cohort study.下肢假肢使用者的活动能力、接受腔适配性、舒适度及社区参与度:一项柬埔寨队列研究。
J Neuroeng Rehabil. 2022 May 2;19(1):42. doi: 10.1186/s12984-022-01021-7.
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Scoping review to evaluate existing measurement parameters and clinical outcomes of transtibial prosthetic alignment and socket fit.范围综述以评估经胫骨假肢对线和接受腔适配的现有测量参数及临床结果。
Prosthet Orthot Int. 2022 Apr 1;46(2):95-107. doi: 10.1097/PXR.0000000000000061.
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[Correlation among tests and functional assessment scales in the follow-up of prosthetic adaptation in people with lower limb amputation].[下肢截肢患者假肢适配随访中各项测试与功能评估量表之间的相关性]
Rehabilitacion (Madr). 2022 Apr-Jun;56(2):116-124. doi: 10.1016/j.rh.2020.11.001. Epub 2021 Feb 26.
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Factors Associated With Prolonged Length of Stay and Failed Lower Limb Prosthetic Fitting During Inpatient Rehabilitation.住院康复期间与住院时间延长及下肢假肢装配失败相关的因素。
Arch Rehabil Res Clin Transl. 2020 Sep 19;2(4):100084. doi: 10.1016/j.arrct.2020.100084. eCollection 2020 Dec.
9
Factors affecting activities of daily living, physical balance, and prosthesis adjustment in non-traumatic lower limb amputees.影响非创伤性下肢截肢者日常生活活动、身体平衡及假肢适配的因素。
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Lower limb prosthetic interfaces: Clinical and technological advancement and potential future direction.下肢假肢接口:临床和技术进步及潜在未来方向。
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