背景:为了补偿截肢时移除的下肢的解剖和生物力学冲击吸收特征,通常将减轻冲击的桥架安装到假体上。然而,关于它们的减震能力的研究是高度可变的,到目前为止,尚未审查,使它们难以在临床实践中解释和应用。
目的:综合和评估现有文献,研究与下肢截肢者中刚性桥架相比,减震桥架在减轻肢体负荷时的冲击效果。
方法:系统评价。
方法:使用有关截肢水平的搜索词对七个数据库进行了全面搜索,冲击衰减和刚性塔以及冲击衰减的措施。在使用改编自Cochrane手册的交叉研究质量评估标准评估合格的文章之前,对已建立的纳入和排除标准进行筛选。
结果:有9篇文章符合入选条件。虽然有一个趋势在研究表明只有有限的积极作用的冲击衰减塔衰减瞬态冲击力,对研究设计的限制,即,在采样中,对方法细节的不良报告和结果的异质性使得对结果的结论性解释变得困难.
结论:虽然目前的文献与减震塔制造商提出的主张不一致,这不足以最终确定减震塔的有效程度,与传统的刚性塔相比,在削弱下肢截肢者之间的瞬态冲击力。需要更高质量的研究来更好地指导临床实践中有关减震成分处方的决策。临床相关性如果交付良好,研究可以为临床医生提供客观可靠的数据,可以在实践中应用于指导成分处方。然而,研究的方法论限制可能会损害研究结果的可靠性,从而产生潜在的误导性结果。必须认识和理解这些限制,以便可以准确地解释和适当地应用发现。
BACKGROUND: Shock-attenuating pylons are commonly fitted to prostheses in order to compensate for the anatomical and biomechanical shock-absorbing features of the lower limb removed upon amputation. However, studies concerning their shock-attenuating capacity are highly variable and, to date, have not yet been reviewed, making them difficult to interpret and apply in clinical practice.
OBJECTIVE: To synthesise and appraise the available literature examining the effectiveness of shock-attenuating pylons in attenuating shock upon limb loading compared to rigid pylons among lower limb amputees.
METHODS: Systematic
review.
METHODS: A comprehensive search of seven databases was conducted using search terms concerning amputation level, shock-attenuating and rigid pylons as well as measures of shock attenuation. All studies yielded were screened against established inclusion and exclusion criteria before eligible articles were appraised using the Quality Assessment Standard for Crossover Studies adapted from the Cochrane handbook.
RESULTS: Nine articles were eligible for inclusion. While there was a trend among studies to indicate only a limited positive effect of shock-attenuating pylons in attenuating transient impact forces, limitations to the study designs, namely, in sampling, poor reporting of methodological details and heterogeneity of outcomes made conclusive interpretation of results difficult.
CONCLUSIONS: While the current body of literature does not reconcile with claims made by manufacturers of shock-attenuating pylons, it is insufficient to conclusively determine how effective shock-attenuating pylons are, in comparison with conventional rigid pylons, in attenuating transient impact forces among lower limb amputees. Higher quality research is required to better guide decisions regarding prescription of shock-attenuating componentry in clinical practice. Clinical relevance When delivered well, research can provide clinicians with objective and reliable data that can be applied in their practice to guide prescription of componentry. However, methodological limitations to research may compromise the reliability of findings, thereby producing potentially misleading outcomes. These limitations must be recognised and appreciated such that findings may be interpreted accurately and applied appropriately.