Gait and rehabilitation in lower limb amputees: a narrative review v1

2021 ◽  
Author(s):  
Irene Aprile ◽  
Marco Gallotti ◽  
Marco Germanotta ◽  
Pasquale Alessio Sauchelli
Keyword(s):  
Gait Analysis ◽  
Lower Limb ◽  
Data Extraction ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Narrative Review ◽  
Study Selection ◽  
Assess Quality ◽  
Lower Limb Amputees

Introduction:Even if gait analysis is a validated outcome measure to assess the effects of a rehabilitation program on gait performance, few articles have been produced about the evaluation of a rehabilitation program in lower limb amputees using the gait analysis as a measure of outcome. Inclusion criteria:The inclusion criteria of the following narrative review is to investigate all the studies, without year limitations but only in English, whose population was lower limb adult amputees that underwent a rehabilitation process evaluated through the use of the gait analysis as a measure of outcome. Methods:Three databases will be investigated: Scopus, Pubmed and Embase, without year limitations but only in English. Study selection will be done following the inclusion and exclusion criteria, data extraction will follow the review’s objectives. Agree II scale will be used to assess the quality of guidelines, Amstar 2 scale will be used to evaluate systematic review, Pedro scale will be used to assess quality of randomized controlled trial, Stard-2015 scale will be used to assess observational studies. Two reviewers will screen the articles in blind and a third reviewer will solve the conflicts raised. Objective:The aim of this narrative review will be the investigation of the extent, type and results of evidence in relation to gait and rehabilitation in lower limb amputees.  

scholarly journals Effects of phantom exercises on pain, mobility, and quality of life among lower limb amputees; a randomized controlled trial

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Zaheer ◽  
Arshad Nawaz Malik ◽  
Tahir Masood ◽  
Sahar Fatima
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Controlled Trial ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Experimental Group ◽  
Lower Limb Amputees

Abstract Background The objective of the current study is to evaluate the effects of phantom exercises on phantom limb pain, mobility status, and quality of life in lower limb amputees treated with mirror therapy and routine physiotherapy. Methods It is a randomized controlled trial in which 24 unilateral lower limb amputees (above and below the knee) were randomly assigned to two equal groups i.e., control group (mirror therapy and conventional physical therapy) and experimental group in which, phantom exercises were given, additionally. Physical therapy included conventional therapeutic exercises while phantom exercises include imagining the movement of the phantom limb and attempting to execute these movements Data were collected at baseline, after 2 and 4 weeks of intervention using VAS (pain), AMP (mobility) and RAND SF-36 Version 1.0 (QOL) questionnaires. All statistical analyses were done with IBM SPSS 25.0 with 95% CI. Results Twenty-four amputees (17 males and 7 females) participated in this trial. The Mean age of the participants in experimental and control groups was 45.3 ± 11.1 years and 40.5 ± 12.5 years respectively. After the intervention, the pain (VAS score) was significantly lower in the experimental group (p = 0.003). Similarly, the experimental group demonstrated a significantly better score in the “bodily pain” domain of SF-36 (p = 0.012). Both groups significantly (p < 0.05) improved in other domains of SF-36 and ambulatory potential with no significant (p > 0.05) between-group differences. Conclusions The Addition of phantom exercises resulted in significantly better pain management in lower limb amputees treated with mirror therapy and routine physiotherapy. Trial registration This study is registered in the U.S National Library of Medicine. The clinical trials registration number for this study is NCT04285138 (ClinicalTrials.gov Identifier) (Date: 26/02/2020).

scholarly journals Task-oriented exercises improve disability of working patients with surgically-treated proximal humeral fractures. A randomized controlled trial with one-year follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Monticone ◽  
Igor Portoghese ◽  
Daniele Cazzaniga ◽  
Valentina Liquori ◽  
Giuseppe Marongiu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Rehabilitation Program ◽  
Group Differences ◽  
Randomized Controlled ◽  
Secondary Outcomes ◽  
One Year ◽  
Task Oriented

Abstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF. Methods By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients’ specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05). Results Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up. Conclusions A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months. Trial registration On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552.

Mobility, prosthesis use and health-related quality of life of bilateral lower limb amputees from the 2008 Sichuan earthquake

2018 ◽  
Vol 43 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Wing Sum Li ◽  
Sze Ying Chan ◽  
Wai Wang Chau ◽  
Sheung-wai Law ◽  
Kai Ming Chan
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Sichuan Earthquake ◽  
Factors Associated ◽  
Rehabilitation Outcomes ◽  
Related Quality ◽  
Health Related ◽  
Bilateral Lower Limb ◽  
Lower Limb Amputees

Background: The 2008 Sichuan Earthquake resulted in many amputees, yet due to the rare incidence, few studies have explored the rehabilitation outcomes and quality of life of bilateral lower limb amputees after major natural disasters. Objectives: To evaluate rehabilitation outcomes of 17 young and adult bilateral lower limb amputees under the StandTall rehabilitation programme and to identify factors associated with successful functional recovery of bilateral amputees after large-scale disasters. Study Design: Cross-sectional study. Methods: Mobility (amputee mobility predictor), prosthesis use (Houghton Scale) and health-related quality of life (Trinity Amputation and Prosthesis Experience Scale, Short Form 12) were evaluated through questionnaires and performance-based assessments. Means of scores were compared using T-tests. Results: Subjects with bilateral through-knee or transtibial amputations had less activity restriction ( p < 0.01) and higher mobility ( p = 0.03). Subjects using prostheses more than 50% waking time had better general adjustment ( p = 0.02) and less functional restriction ( p = 0.01). Exercise and education were associated with higher mobility ( p = 0.06) and mental quality of life, respectively ( p = 0.09). Conclusions: Amputation level and knee joint salvage, prosthesis use, exercise and education were associated with better rehabilitation outcomes including ambulation, adjustment and quality of life in bilateral lower limb amputees from the 2008 Sichuan Earthquake. Clinical relevance The study examined a unique group of traumatic bilateral lower limb amputees who were young and healthy before having traumatic amputations from a single episode of natural disaster. The factors associated with better functional recovery after the earthquake were investigated and may support future development of post-disaster rehabilitation strategies for bilateral lower limb amputees.

scholarly journals Quality assessment of systematic reviews and meta-analyses that examine preventive antibiotic uses and management practices designed to prevent disease in livestock

2019 ◽  
Vol 20 (2) ◽  
pp. 305-318
Author(s):  
Rachael Vriezen ◽  
Jan M. Sargeant ◽  
Ellen Vriezen ◽  
Charlotte B. Winder ◽  
Annette M. O'Connor
Keyword(s):  
Quality Assessment ◽  
Systematic Reviews ◽  
Management Practices ◽  
Disease Risk ◽  
Data Extraction ◽  
A Priori ◽  
Antibiotic Use ◽  
Study Selection ◽  
Meta Analyses

AbstractTo implement effective stewardship in food animal production, it is essential that producers and veterinarians are aware of preventive interventions to reduce illness in livestock. Systematic reviews and meta-analyses (SR/MA) provide transparent, replicable, and quality-assessed overviews. At present, it is unknown how many SR/MA evaluate preventive antibiotic use or management practices aimed at reducing disease risk in animal agriculture. Further, the quality of existing reviews is unknown. Our aim was to identify reviews investigating these topics and to provide an assessment of their quality. Thirty-eight relevant reviews were identified. Quality assessment was based on the AMSTAR 2 framework for the critical appraisal of systematic reviews. The quality of most of the reviews captured was classified as critically low (84.2%, n = 32/38), and only a small percentage of the evaluated reviews did not contain critical weaknesses (7.9%, n = 3/38). Particularly, a small number of reviews reported the development of an a priori protocol (15.8%, n = 6/38), and few reviews stated that key review steps were conducted in duplicate (study selection/screening: 26.3%, n = 10/38; data extraction: 15.8%, n = 6/38). The development of high-quality reviews summarizing evidence on approaches to antibiotic reduction is essential, and thus greater adherence to quality conduct guidelines for synthesis research is crucial.

Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees

2011 ◽  
Vol 35 (2) ◽  
pp. 201-206 ◽  
Author(s):  
Semra Topuz ◽  
Özlem Ülger ◽  
Yavuz Yakut ◽  
Fatma Gül Şener
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Lower Limb ◽  
Nottingham Health Profile ◽  
Measurement Tool ◽  
Turkish Version ◽  
Activity Restriction ◽  
The Trinity ◽  
Lower Limb Amputees

Background: In Turkey there is no amputee-specific instrument to measure health-related quality of life in lower limb amputees. Objectives: To evaluate the validity and reliability of a Turkish version of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Study design: Outcome study to determine test–retest reliability and construct validity of the adapted Turkish version of the TAPES. Methods: After translation/retranslation of the TAPES, the Turkish version of the TAPES was applied to 47 amputees. A quality of life evaluation (Nottingham Health Profile), a satisfaction evaluation (Satisfaction with Prosthesis), and a functional assessment tool (Amputee Mobility Predictor) were also performed and analysed. Results: On the basis of retesting, the Turkish version of the TAPES was observed to be reliable. The first domain of the Turkish version, which includes psychosocial adjustment, activity restriction and satisfaction with the prosthesis, was found to be valid. However, the validity of the second domain could not be analysed. Conclusions: The Turkish version of the multidimensional TAPES survey is valid and reliable in Turkish unilateral lower limb amputees and may be used in clinical situations to assess the needs of amputees. Clinical relevance The Turkish version of the TAPES quality-of-life measurement tool for amputees is a valid instrument for assessing the effectiveness of rehabilitation and clinical applications.

scholarly journals Assessment of the quality of life of lower-limb amputees with orthosis

2015 ◽  
Vol 58 ◽  
pp. e18-e19
Author(s):  
M. Rekik ◽  
A. Haj Salah ◽  
M. Sghir ◽  
I. Ksibi ◽  
W. Said ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Lower Limb Amputees
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