Abstract：
Structural musculoskeletal adaptations following amputation, such as bone mineral density (BMD) or muscle architecture, are often overlooked despite their established contributions to gait rehabilitation and the development of adverse secondary physical conditions. The purpose of this review is to provide a summary of the existing literature investigating musculoskeletal adaptations in individuals with major lower-limb amputations to inform clinical practice and provide directions for future research. Google Scholar, PubMed, and Scopus were searched for original peer-reviewed studies that included individuals with transtibial or transfemoral amputations. Summary data of twenty-seven articles indicated reduced BMD and increased muscle atrophy in amputees compared to controls, and in the amputated limb compared to intact and control limbs. Specifically, BMD was reduced in T-scores and Z-scores, femoral neck, and proximal tibia. Muscle atrophy was evidenced by decreased thigh cross-sectional area, decreased quadriceps thickness, and increased amounts of thigh fat. Overall, amputees have impaired musculoskeletal health. Future studies should include dysvascular etiologies to address their effects on musculoskeletal health and functional mobility. Moreover, clinicians can use these findings to screen increased risks of adverse sequelae such as fractures, osteopenia/porosis, and muscular atrophy, as well as target specific rehabilitation exercises to reduce these risks.
摘要：
截肢后的结构性肌肉骨骼适应，如骨矿物质密度（BMD）或肌肉结构，尽管它们对步态康复和不利的次要身体状况的发展做出了贡献，但它们经常被忽视。这篇综述的目的是总结现有文献，研究下肢严重截肢患者的肌肉骨骼适应，为临床实践提供信息，并为未来的研究提供方向。谷歌学者，PubMed,和Scopus被搜索原始同行评审的研究,包括经胫骨或股骨截肢的个体.27篇文章的摘要数据表明，与对照组相比，截肢者的BMD降低，肌肉萎缩增加。与完整和对照肢体相比，截肢肢体。具体来说,BMD在T评分和Z评分上降低,股骨颈,和胫骨近端.肌肉萎缩表现为大腿横截面积减小,股四头肌厚度减少，大腿脂肪的增加。总的来说,截肢者的肌肉骨骼健康受损。未来的研究应包括血管异常病因，以解决其对肌肉骨骼健康和功能移动性的影响。此外，临床医生可以利用这些发现来筛查骨折等不良后遗症的风险增加，骨质减少/骨质疏松，肌肉萎缩,以及针对特定的康复锻炼来降低这些风险。
