Authors
Bragaru, M; Dekker, R; Geertzen, JHB and Dijkstra,
PU
Date
2011
Keywords
Sport; sport participation; amputees.
Country of research
Netherlands
Summary of findings
This is a systematic review of literature and
research relating to a variety of aspects of amputees’
participation in sports: biomechanics, cardiopulmonary function,
psychological aspects, sports participation and physical
functioning and sports injuries. Following an extensive
search of databases the authors identified 3,689 papers, of which
only 47 (1.3%) met their specific criteria. All papers are
listed providing the details of methods, amputee characteristics,
study design and results. Most were older than 10 years and
had cross-sectional designs. Study participants were
generally younger and often had more traumatic amputations than the
general population of individuals with limb amputations. The
heterogeneity of population characteristics, intervention types and
main outcomes made pooling of data impossible. The findings
are accompanied by advice about the implementation of exercise and
sports programmes.
Participation in a variety of relevant sports
(related to individual capabilities) and physical activity was
found to positively influence physical fitness, psychosocial
well-being and physical functioning. Interestingly data
indicates that in Europe only between 11% and 39% of amputees take
part in sport, compared to an estimated 61% in the USA.
Studies have identified different factors influencing participation
in sports for this group, but there is no overall agreement.
The review provides brief information on limitations on certain
activities such as running and long-jumping and the role of
prosthetic limbs (although the evidence suggests that most do not
use prostheses [note: most of these studies are at least 10 years
old]). Cardiopulmonary function was better when a simple
physical exercise programme was included (the intensity of which
needs to be tailored to individual abilities).
The psychological impact of the disability on
athletes with limb amputations was found to be smaller as compared
to those with other disabilities. Participation in sports and
physical activities had a positive influence on self-esteem,
perceived body image and locus of control. In general the
benefits of sports participation outweigh the inconvenience of the
disability. There is some indication that participants improve
their mobility skills, personal relationships and the acceptance of
their own disability. The evidence in relation to physical
functioning, mobility and activity level including age, aetiology,
amputation level and previous sports participation is mixed and
difficult to draw conclusions. Sport-related muscle pain was
more frequent among limb amputees than others with different
physical disabilities. The limited nature of the research
made it difficult to identify disability-specific injury rates or
patterns. Also the sports which individuals with limb
amputations prefer – fishing, swimming, golf – were not
investigated.
The authors caution that the review findings should be
treated with caution because only few studies had a high
methodological value. However, their overall conclusion is
that participating in sports or physical activity is beneficial for
those with lower limb amputations, with the psychosocial benefits
being at least equal to those experienced by able-bodied
people. Further research should focus on the inclusion of a
larger variety of sports and individuals with upper limb
amputations and the influence of sports on quality of life needs to
be more thoroughly investigated, along with determinants of
participation. Finally a physical training programme to
improve cardiopulmonary function as part of a rehabilitation
programme should be developed and tested for its
efficacy.
Methodology
Systematic review
Source of reference
Sports Medicine, 41(9), 721-740
Web reference
http://adisonline.com/sportsmedicine/toc/2011/41090