The Impact of the Immediate Postoperative Prosthesis on Patient Mobility and Quality of Life after Transtibial Amputation
The Impact of the Immediate Postoperative Prosthesis on Patient Mobility and Quality of Life after Transtibial Amputation
复制标题
术后即刻假肢对小腿截肢后患者活动能力和生活质量的影响
DOI：
10.1097/phm.0000000000000553
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发表时间：
2017
影响因子：
3
通讯作者：
F. Sim
中科院分区：
文献类型：
--
作者：
B. Samuelsen;K. Andrews;M. Houdek;Marisa J. Terry;T. Shives;F. Sim
研究背景：术后即刻假体的使用可以使患者早期活动，对患者的身体和心理都有潜在的益处。本研究使用加速度计和有效的问卷调查，前瞻性地检查经胫骨截肢后立即接受术后假体的患者的活动水平和生活质量数据。方法10例患者纳入研究。平均年龄为58岁（范围，22 - 69岁），有9名男性和1名女性，截肢的原因是9名患者的坏疽性溃疡不愈合和1名患者的肢体缺血。患者随访6周。活动数据收集在ActiGraph GT3X加速度计上，并使用ActiLife 6数据分析软件进行分析。在术后6周访视时，进行截肢者活动预测临床医生评定的性能评价，并完成简表-36问卷。结果本组患者平均88%（83%~92%）的时间是久坐不动，11.5%（7.6%~16.9%）的时间是轻度体力活动，0.3%（0.12%~1.36%）的时间是中度至剧烈体力活动。在预期功能水平和记录的活动水平之间未观察到统计学显著关系。患者的身体和情感简表-36分量评分较低。结论经胫骨截肢患者术后早期即使立即进行了假体敷料，但仍非常久坐不动。
Background The immediate postoperative prosthesis has been purported to allow early mobilization with potential physical and psychologic benefits to patients. This study used accelerometers and validated questionnaires to prospectively examine activity level and quality of life data for patients receiving an immediate postoperative prosthesis after transtibial amputation. Methods A total of 10 patients were included in the study. Mean age was 58 yrs (range, 22–69 yrs), there were 9 men and 1 woman, and reason for amputation was nonhealing gangrenous ulcer in 9 patients and ischemic limb in 1 patient. Patients were followed for 6 wks. Activity data were collected on ActiGraph GT3X accelerometers and analyzed using ActiLife 6 Data Analysis Software. At the 6-wk postoperative visit, an Amputee Mobility Predictor clinician-rated performance evaluation was conducted and a Short Form-36 questionnaire was completed. Results Patients in the cohort spent an average of 88% (range, 83%–92%) of their time sedentary, 11.5% (range, 7.6%–16.9%) of their time in light physical activity, and 0.3% (range, 0.12%–1.36%) of their time in moderate to vigorous physical activity. No statistically significant relationships were observed between expected level of function and recorded activity level. Patients had low physical and emotional Short Form-36 component scores. Conclusions Patients with transtibial amputations were extremely sedentary in the early postoperative period despite their immediate postoperative prosthesis dressings.