Rehabilitation Techniques for Adults Undergoing External Fixation Treatment for Lower Limb Reconstruction: A Systematic Review.

IF 1 Q3 ORTHOPEDICS

Strategies in Trauma and Limb Reconstruction Pub Date : 2024-01-01 DOI:10.5005/jp-journals-10080-1609

Jessica R Pawson, Daniel Church, Joanna Fletcher, Rebecca Al Wood, Catherine Hilton, James Lloyd, Jade Brien, Kathryn C Collins

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引用次数: 0

Abstract

Introduction: External fixation devices are commonly used in orthopaedic surgery to manage a range of pathologies. In this patient population, there is currently no consensus on optimal rehabilitation techniques. There exists a large variation in practice, with a limited understanding of how these affect treatment outcomes.

Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic review was conducted of Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PEDro, and COCHRANE databases, grey literature sources and forward and backward searching of included articles. Studies were selected following rigorous screening with predefined inclusion criteria. Data quality was assessed using validated appraisal tools. Articles were synthesised by rehabilitation type and descriptive analysis was subsequently performed.

Results: From 1,156 articles identified, 18 were eligible for inclusion. The overall quality was low, with clinical commentaries and case studies being the most common study type. Studies were synthesised by rehabilitation type, the most common themes being gait re-education, strengthening, therapy-assisted, active exercises and weight-bearing exercises.

Conclusion: There is a lack of high-quality evidence to support meaningful recommendations and guide rehabilitation practices for this patient cohort. Further research for patients being treated in external fixation, especially related to the potential effects of physical rehabilitation on bone healing, return of strength, mobility and independent function is likely to have transferability within wider orthopaedic populations.

Clinical significance: This systematic review is unable to provide clinical recommendations due to the poor quality of the available literature. However, it is hoped this paper will provide a foundation for further research to improve rehabilitation for patients being treated with external fixation.

How to cite this article: Pawson JR, Church D, Fletcher J, et al. Rehabilitation Techniques for Adults Undergoing External Fixation Treatment for Lower Limb Reconstruction: A Systematic Review. Strategies Trauma Limb Reconstr 2024;19(1):45-55.

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成人下肢重建外固定治疗的康复技术：系统回顾

导言：外固定装置通常用于矫形外科手术，以治疗各种病症。对于这类患者，目前尚未就最佳康复技术达成共识。在实践中存在着很大的差异，对这些差异如何影响治疗效果的理解也很有限：方法：根据系统综述和荟萃分析首选报告项目（PRISMA）指南，对联合和补充医学数据库（AMED）、护理和联合健康文献累积索引（CINAHL）、MEDLINE、PEDro 和 COCHRANE 数据库、灰色文献来源进行了系统综述，并对纳入的文章进行了正向和反向检索。根据预先确定的纳入标准对研究进行严格筛选。数据质量采用经过验证的评估工具进行评估。文章按康复类型进行综合，随后进行描述性分析：在确定的 1,156 篇文章中，有 18 篇符合纳入条件。总体质量较低，临床评论和病例研究是最常见的研究类型。研究按康复类型进行了综合，最常见的主题是步态再教育、强化、治疗辅助、主动锻炼和负重锻炼：结论：目前缺乏高质量的证据来支持有意义的建议并指导这类患者的康复实践。针对接受外固定治疗的患者开展的进一步研究，尤其是与物理康复对骨愈合、力量恢复、活动能力和独立功能的潜在影响有关的研究，很可能会在更广泛的骨科人群中推广：由于现有文献质量不高，本系统综述无法提供临床建议。不过，我们希望本文能为进一步的研究奠定基础，以改善接受外固定治疗的患者的康复情况：Pawson JR、Church D、Fletcher J 等：《接受外固定治疗的成人下肢重建康复技术》：系统回顾Strategies Trauma Limb Reconstr 2024;19(1):45-55.

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来源期刊

Strategies in Trauma and Limb Reconstruction Medicine-Orthopedics and Sports Medicine

CiteScore

1.50

自引率

0.00%

发文量

期刊介绍： Strategies in Trauma and Limb Reconstruction is dedicated to surgeons, allied medical professionals and researchers in the field of orthopaedics and trauma. The scope of the journal is to discuss the fields of skeletal injury, and the complications thereof, congenital and acquired limb deformities and deficiencies, and orthopaedic-related infection, together with their surgical and non-surgical treatments. The journal publishes original articles, reviews, case reports, descriptions of new or recognised treatment techniques, forum discussions of clinical scenarios and relevant correspondence. It aims to provide a widely accessible source of useful information to practitioners in the field through the problem- or technique-based approach of published articles.