Alterations in Spatiotemporal Parameters in Patients With Lower-Limb Amputation: A Systematic Review With Meta-Analysis.

چکیده اصلی

OBJECTIVES: To evaluate differences in spatiotemporal gait parameters in individuals with transfemoral (TFA) and transtibial amputation (TTA) compared with physically able individuals. METHODS: This systematic review with meta-analysis was conducted according to the MOOSE guidelines. Cross-sectional studies or clinical trials that assessed spatiotemporal gait parameters in adults with unilateral TFA or TTA were included. Searches were performed in Medline (via PubMed), CINAHL, Scopus, LILACS, Cochrane Library, and Embase using descriptors related to amputation and gait. Risk of bias was assessed using the Joanna Briggs Institute scale for cross-sectional studies, whereas the meta-analysis was performed using quantitative data for the following outcomes: walking speed, step length, stride length, step width, cadence, stance time, swing time, step time, or stride time. RESULTS: A total of 12 cross-sectional studies involving 150 individuals with amputation (86 TTA and 64 TFA) and 138 healthy controls were included. Meta-analysis demonstrated a significant reduction in walking speed (mean difference of -0.24; 95% CI -0.32 to -0.17; p < 0.0001; I2 = 61%) and cadence (mean difference of -6.01; 95% CI -9.69 to -2.34; p = 0.001; I2: 54%) in patients with amputation compared with healthy individuals. A reduction in stride length (mean difference of -11.71; 95% CI -23.37 to -0.04; p = 0.05; I2: 85%) and an increase in step width (mean difference of 5.22; 95% CI 2.99 to 7.45; p < 0.0001; I2: 71%) were also observed. Step time showed no significant difference between groups (mean difference of 0.06; 95% CI -0.01 to 0.14; p = 0.11; I2: 93%). Patients with TFA amputation exhibited greater impairment in gait variables, particularly cadence, when compared with a healthy individual. CONCLUSIONS: Patients with lower limb amputation present with functionally compromised gait, characterized by reduced walking speed. Increased step width and reduced stride length are findings that may suggest compensatory strategies during gait and improved balance, which are important requirements for amputee patients. These findings reinforce the need for rehabilitation interventions focused on improving propulsion and postural safety. TRIAL REGISTRATION: PROSPERO: CRD42024620098.

ترجمه فارسی چکیده

هدف این مرور سیستماتیک و آنالیز متا، ارزیابی تفاوت‌های پارامترهای راه رفتن مکانی و زمانی در افراد دارای قطع عضو تحتانی (TFA و TTA) در مقایسه با افراد سالم بود. این مطالعه بر اساس دستورالعمل‌های MOOSE انجام شد. ۱۲ مطالعه مقطعی شامل ۱۵۰ فرد دارای قطع عضو (۸۶ TTA و ۶۴ TFA) و ۱۳۸ کنترل سالم وارد تحلیل شدند. نتایج نشان داد کاهش معنی‌دار سرعت راه رفتن و تعداد گام در بیماران نسبت به افراد سالم. همچنین کاهش طول قدم و افزایش عرض قدم مشاهده شد. زمان گام تفاوت معنی‌داری نداشت. بیماران با قطع عضو تیفمورال (TFA) آسیب بیشتری در متغیرهای راه رفتن، به‌ویژه تعداد گام، داشتند.

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