Eric J. Earley PhD , Dan W. Milius CPO , Mohamed E. Awad MD, MBA , Danielle H. Melton MD , Kirstin Ahmed PhD , Ruud A. Leijendekkers PT, PhD , Benjamin K. Potter MD , Phillip M. Stevens MEd, CPO , Brecca M.M. Gaffney PhD , Cory L. Christiansen PT, PhD , Jason W. Stoneback MD
{"title":"建立经股骨锚定肢体假体成分处方共识:一项国际德尔菲法研究。","authors":"Eric J. Earley PhD , Dan W. Milius CPO , Mohamed E. Awad MD, MBA , Danielle H. Melton MD , Kirstin Ahmed PhD , Ruud A. Leijendekkers PT, PhD , Benjamin K. Potter MD , Phillip M. Stevens MEd, CPO , Brecca M.M. Gaffney PhD , Cory L. Christiansen PT, PhD , Jason W. Stoneback MD","doi":"10.1016/j.apmr.2025.06.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To guide prosthetic componentry prescription for patients with bone-anchored limbs (BALs), we established the first international consensus on prosthetic component selection for transfemoral BALs using the Delphi method.</div></div><div><h3>Design</h3><div>Three-round Delphi study taking place between November 2023 and September 2024.</div></div><div><h3>Setting</h3><div>Anonymous digital surveys were distributed to delegates in the United States, Sweden, the Netherlands, Australia, and Canada.</div></div><div><h3>Participants</h3><div>Eighteen (N=18) worldwide clinical experts in prosthetic care for patients with BAL participated as delegates.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>Thematic statement consensus was defined as delegate agreement of at least 80%.</div></div><div><h3>Results</h3><div>Thirty-four out of 48 thematic statements pertaining to individual prosthetic components and prescriptions for patients with BALs achieved general agreement consensus. There was strong agreement that prosthesis prescription should not change on the basis of sex or age, but rather on the physical ability and desired functional activities of the patient. The consensus reached aligns with current clinical practice guidelines for lower limb socket prostheses, such as the use of microprocessor knees. Other findings highlighted areas of uncertainty among experts, such as whether the implant and bone should be protected against high loads in the coronal or sagittal planes with prosthetic safety hardware.</div></div><div><h3>Conclusions</h3><div>The themes identified here can serve to guide clinicians in the selection of prosthetic components as further evidence is created to promote safety and functional outcomes for individuals with BALs. This consensus provides a basis for structuring future clinical practice guidelines and identifying knowledge gaps for future research studies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 10","pages":"Pages 1565-1574"},"PeriodicalIF":3.7000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Establishing Consensus for Prescription of Prosthetic Components for Transfemoral Bone-Anchored Limbs: An International Delphi Method Study\",\"authors\":\"Eric J. Earley PhD , Dan W. Milius CPO , Mohamed E. Awad MD, MBA , Danielle H. Melton MD , Kirstin Ahmed PhD , Ruud A. Leijendekkers PT, PhD , Benjamin K. Potter MD , Phillip M. Stevens MEd, CPO , Brecca M.M. Gaffney PhD , Cory L. Christiansen PT, PhD , Jason W. Stoneback MD\",\"doi\":\"10.1016/j.apmr.2025.06.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To guide prosthetic componentry prescription for patients with bone-anchored limbs (BALs), we established the first international consensus on prosthetic component selection for transfemoral BALs using the Delphi method.</div></div><div><h3>Design</h3><div>Three-round Delphi study taking place between November 2023 and September 2024.</div></div><div><h3>Setting</h3><div>Anonymous digital surveys were distributed to delegates in the United States, Sweden, the Netherlands, Australia, and Canada.</div></div><div><h3>Participants</h3><div>Eighteen (N=18) worldwide clinical experts in prosthetic care for patients with BAL participated as delegates.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>Thematic statement consensus was defined as delegate agreement of at least 80%.</div></div><div><h3>Results</h3><div>Thirty-four out of 48 thematic statements pertaining to individual prosthetic components and prescriptions for patients with BALs achieved general agreement consensus. There was strong agreement that prosthesis prescription should not change on the basis of sex or age, but rather on the physical ability and desired functional activities of the patient. The consensus reached aligns with current clinical practice guidelines for lower limb socket prostheses, such as the use of microprocessor knees. Other findings highlighted areas of uncertainty among experts, such as whether the implant and bone should be protected against high loads in the coronal or sagittal planes with prosthetic safety hardware.</div></div><div><h3>Conclusions</h3><div>The themes identified here can serve to guide clinicians in the selection of prosthetic components as further evidence is created to promote safety and functional outcomes for individuals with BALs. This consensus provides a basis for structuring future clinical practice guidelines and identifying knowledge gaps for future research studies.</div></div>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\"106 10\",\"pages\":\"Pages 1565-1574\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0003999325007701\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003999325007701","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Establishing Consensus for Prescription of Prosthetic Components for Transfemoral Bone-Anchored Limbs: An International Delphi Method Study
Objective
To guide prosthetic componentry prescription for patients with bone-anchored limbs (BALs), we established the first international consensus on prosthetic component selection for transfemoral BALs using the Delphi method.
Design
Three-round Delphi study taking place between November 2023 and September 2024.
Setting
Anonymous digital surveys were distributed to delegates in the United States, Sweden, the Netherlands, Australia, and Canada.
Participants
Eighteen (N=18) worldwide clinical experts in prosthetic care for patients with BAL participated as delegates.
Interventions
None.
Main Outcome Measures
Thematic statement consensus was defined as delegate agreement of at least 80%.
Results
Thirty-four out of 48 thematic statements pertaining to individual prosthetic components and prescriptions for patients with BALs achieved general agreement consensus. There was strong agreement that prosthesis prescription should not change on the basis of sex or age, but rather on the physical ability and desired functional activities of the patient. The consensus reached aligns with current clinical practice guidelines for lower limb socket prostheses, such as the use of microprocessor knees. Other findings highlighted areas of uncertainty among experts, such as whether the implant and bone should be protected against high loads in the coronal or sagittal planes with prosthetic safety hardware.
Conclusions
The themes identified here can serve to guide clinicians in the selection of prosthetic components as further evidence is created to promote safety and functional outcomes for individuals with BALs. This consensus provides a basis for structuring future clinical practice guidelines and identifying knowledge gaps for future research studies.
期刊介绍:
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.