Table 2 Data summary of included studies
From: Bicycling participation in people with a lower limb amputation: a scoping review
Authors (year) | Country | Study design | LLA No, Male | Age (mean ± SD/ range) | Amp Characteristics | Results | ||
|---|---|---|---|---|---|---|---|---|
Cause | Level | Uni/Bilat | ||||||
Bicycling participation | ||||||||
**Burger et al. (1997) [32] | Slovenia | CS | 228, 84% | 53.3 ± 15.4 | 100%T | 108TF, 114TT, 2KD, 4HD | NR | Recreation: • Before amputation: 38% bicycling • After amputation: 11% bicycling |
Kars et al. (2009) [36] | Netherlands | CS | 105, 66% | 23–79 | 40% PVD, 31% T, 10% C, 19% other | 27TF, 58TT, 1Hemipelvectomy, 5HD, 13KD, 1 AD | 101/4 | Sport: • 6% bicycling for sport • A minimal duration of half an hour of participation is required for sports |
Sprunger et al. (2012) [37] | USA | CS | 58 (100%VA) | 48.3 ± 14.3 | 88% T, 12% PVD, DM, C, or infection | 22 Gr1, 26 Gr2, 10 Gr3 | 48/10 | Sport: • 45% bicycling (most popular) |
Bragaru et al. (2013) [35] | Netherlands | CS | 780, 62% | 59.6 ± 14.8 | 27% PVD/DM, 73% non-PVD | 261TF, 432TT, 87KD | 736/44 | Sports with a prosthesis: • Athletes are persons who joined sport at least 5 h a month • 4% of participants were athletes who cycle with a prosthesis |
Littman et al. (2014) [34] | USA | CS | 158, 98%, (100%VA) | 65 | 36% T, 64%-NR | 41TF, 62TT, 55PF | 125/33 | Physical activities: • 12% bicycling outdoors or on stationary bicycle (9%of PF, 12%of TT and 17% of TF) |
Bicycling participation and facilitators and barriers for transportation | ||||||||
Narang et al. (1984) [27] | India | CS | 500, 95% (60% VA) | 2–65# | 82% T, 17% disease, 1% congenital | 124TF, 308TT | 432/68 | • 48% used bicycle (60% of TT, 35%of TF and 18% of bilat) • 50% did not use bicycle (38%of TT, 63% of TF, 78% of bilat) • 2% never known how to cycle (2% of TT and TF and 4% of bilat) |
**Burger et al. (1997) [33] | Slovenia | CS | 223, 84% | 54.4 ± 15.4 | 100% T | 102TF, 115TT, 2KD, 4HD | 203/20 | • 29% used bicycle • 60%*** did not use bicycle (average 5.7 years older than those who use a bicycle) • 11% did not travel by bicycle both before and after amputation • TT amputees were more likely to bicycle than TF amputees |
Bicycling facilitators and barriers in people with a TTA | ||||||||
Childers et al. (2011) [28]* | USA | RCT | 8, 75% (1Paralympic medalist) (control =9) | 36.4 ± 10.4 | 7 T, 1 C | 8 TT | 8/0 | Pedaling force effectiveness ratio was not significantly different between a STIFF foot and a FLEX foot |
Childers et al. (2011) [29]* | USA | RCT | 8, 75% (1Paralympic medalist) (control =9) | 36.4 ± 10.4 | NR | 8 TT | 8/0 | Pedaling asymmetry in people with a TTA was significantly larger than in controls in low difficulty and time trial conditions (submaximal bicycling over a 6-min period). Work asymmetry was significantly greater than the force asymmetry in TT amputation group between both conditions. Work and force was provided more by the sound limb. Work asymmetry decreased when the STIFF foot was used during the time trial condition. |
Koutny et al. (2013) [26] | Czech Republic | CR | 1, 100% (athlete) | 37 | NR | 1TT | 1/0 | After shortening of the bicycle’s crank at the prosthetic limb, asymmetry of hip and knee kinematic reduced. Besides, muscle activity decreased during bicycling in seated position (vastus medialis, vastus lateralis, and gluteus maximus of both limbs) and climbing position (gluteus maximus of amputated limb). The sound side significantly produced more pedaling forces than the prosthetic side but this asymmetry was not influenced by the crank shortening. |
Dyer and Woolley (2017) [30] | UK | CR | 1, 100% | 33 | NR | 1TT | 1/0 | An aero foil shaped pylon caused less, but not significant, aerodynamic drag than the round shaped pylon in both virtual elevation field and wind tunnel tests. |
Dyer (2017) [31] | UK | Cohort | 41,100% | NR | NR | 41TT | 41/0 | The competitive bicyclists in C4 classification who used prosthesis were not faster when competing in 1 km time trial (world championships and Paralympic games) than the bicyclists without prosthesis. |
Bicycling facilitators and barriers in Van Nes rotationplasty | ||||||||
Mead (2005) [38] | Canada | CR | 1, 100% | 14 | 1 C | 1 Van Nes rotationplasty | 1/0 | Limitation of knee flexion obstructed complete bicycling revolutions. By cutting a crank and adding a hinge in between two crank parts, the outer crank can swing down. The hinged-crank reduced amount of required knee flexion. |
Scheepers et al. (2013) [39] | Netherlands | CR | 1, 100% | 18 | 1 C | 1 Van Nes rotationplasty | 1/0 | The thigh cuff of a conventional prosthesis leads to perspiration, chaffing and skin abrasion in high-intensity bicycling. Replacing the thigh-cuff socket design and conventional prosthesis with the Socket-Less Rotationplasty Prosthesis for Cycling prevented abrasion. |