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Abstract：
Residual limb wounds or ulcers are one of the most frequent skin problems reported by lower extremity prosthesis users. Healing often requires prosthesis disuse, which can logically impair physical functioning. However, there are limited data available to support this idea. We report the impact of prosthesis disuse by presenting assessments of balance, gait, physical activity, and balance confidence obtained on a case subject before experiencing a wound and following reintroduction to a well-fit prosthesis after wound-related prosthesis disuse. The case subject was a 76-year-old male who suffered a unilateral, transtibial amputation due to synovial sarcoma 13 years before. After presenting with a history of pain in the area of a chronic skin plaque, he received a punch biopsy, which resulted in 4 weeks of prosthesis disuse followed by 12 weeks of limited use before a final well-fitting socket was received. The following data were collected 24 weeks before the biopsy and 4 weeks after receiving the final well-fitting socket: Berg Balance Scale, L-test of walking, quantitative gait analysis, Activity-specific Balance Confidence Scale, and 1 week of community-based activity. Balance confidence decreased nearly 19%, walking speed decreased by 12%, and steps/day decreased by 19% following ∼4 months of prosthesis disuse/limited use; functional measures were not impacted. Lower balance confidence is not trivial as it can lead to activity avoidance and increased fall risk. Interventions to target balance confidence changes following prosthesis disuses may be important to minimize the impact of disuse on physical and mental well-being.
摘要：
残肢伤口或溃疡是下肢假体使用者报告的最常见的皮肤问题之一。愈合通常需要停用假体，这在逻辑上会损害身体功能。然而,支持这一想法的数据有限。我们通过提供平衡评估来报告假体废弃的影响，步态,身体活动,在经历伤口之前以及在伤口相关假体废弃后重新引入合适的假体后，在病例受试者上获得的平衡置信度。案件主题是一名76岁的男性，13年前由于滑膜肉瘤引起的胫骨截肢。在慢性皮肤斑块区域出现疼痛病史后，他接受了穿刺活检,这导致了4周的假体废弃，然后是12周的有限使用，然后才接受了最终的良好配合腔。以下数据收集在活检前24周和接受最终良好的插座后4周：Berg平衡量表，L-步行测试，定量步态分析,特定活动平衡信心量表，和一周的社区活动。余额可信度下降近19%，步行速度下降了12%，在假体废弃/有限使用4个月后，步数/天减少了19%；功能措施没有受到影响。较低的平衡置信度并不是微不足道的，因为它可以导致活动避免和跌倒风险增加。假体废弃后目标平衡置信度变化的干预措施对于最大程度地减少废弃对身心健康的影响可能很重要。
