Objective: Comprehensively and objectively assess physical activity, aerobic fitness and body fat in adolescents and young adults with myelomeningocele and to investigate their relationships. Design: Cross-sectional study. Subjects: Fifty-one persons (26 males) with myelomeningocele aged 21.1 (standard deviation) 4.5) years. Methods: Physical activity was measured with an accelerometry-based activity monitor. Aerobic fitness was defined as the maximum oxygen uptake during the last minute of a maximal exercise test. Body fat was assessed using sum of 4 skin-folds and body mass index. Correlations were studied using multiple regression analyses. Results: Thirty-nine percent of the participants were inactive and another 37% were extremely inactive. Aerobic fitness was 42% lower than normative values and 35% were obese. Ambulatory status was related to daily physical activity (β = 0.541), aerobic fitness (β = 0.397) and body fat (β = -0.243). Gender was related to aerobic fitness (β = -0.529) and body fat (β = 0.610). Physical activity was related to aerobic fitness in non-ambulatory persons with myelomeningocele (β = 0.398), but not in ambulatory persons. Conclusion: Adolescents and young adults with myelomeningocele were physically inactive, had poor aerobic fitness and high body fat. Differences exist between subgroups regarding gender and ambulatory status.
Abstract-This study identified which residual-limb quality factors are related to functional mobility 1 year after transtibial (TT) amputation. A group of 28 TT amputees were evaluated with respect to their functional mobility (Prosthesis Evaluation Questionnaire [PEQ], Locomotor Index, Timed Up and Go test). The general (Chakrabarty score) and bony (tibial length, relative fibular length) residual-limb quality factors were assessed. An increase in general residual-limb quality (Chakrabarty >60) was correlated with greater functional mobility in one of the outcome measures (PEQ). For bony residual-limb quality, a tibial length of 12-15 cm distal from the knee joint line was correlated with greater functional outcome for all three outcome measures and the relative fibular length was not correlated with functional mobility for any of the outcome measures. This study showed that specific aspects of residuallimb quality are related to increased functional mobility. The amputation technique and resulting residual-limb factors may be important for patients to achieve functional prosthetic use.
Although the results are largely comparable with other studies, there appear to be differences in age, amputation level and course and duration of treatment. The predicting factors found here may help the rehabilitation specialist in advising on the best moment and level of amputation and course of treatment.
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