Development of an exercise testing protocol for patients with a lower limb amputation: results of a pilot study

Vestering, Myrthe M; Schoppen, Tanneke; Dekker, Rienk; Wempe, Johan B.; Geertzen, Jan H. B.

doi:10.1097/00004356-200509000-00006

Cited by 26 publications

(22 citation statements)

References 13 publications

(12 reference statements)

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“…The maximal oxygen uptake during the exercise testing was 12.1 ml/kg/min on average, while the mean proportion of age-adjusted normative oxygen uptake at maximum exercise power was 57.5%. This makes our study comparable to previous similar research [7,33,36].…”

Section: Discussionsupporting

confidence: 91%

“…At our rehabilitation hospital, exercise testing has therefore been included into the clinical pathway for all the patients after transfemoral amputation due to PVD. Despite some initial doubts [32], hand-wheel ergometry without direct gas analyses has been proven to be a reliable, repeatable and safe method that provides data on physical fitness, heart rhythm problems, hypertensive response to strain and possible low-threshold angina pectoris in ischaemic heart disease [5,26,33]. Rather than using direct gas measurement, we decided to calculate the maximal oxygen uptake according to the ACSM formula [26] because breathing through the mask could pose an unreasonable risk for those in poor physical condition and at high risk for cardiovascular events during exercise testing.…”

Section: Discussionmentioning

confidence: 99%

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Exercise testing as a screening measure for ability to walk with aprosthesis after transfemoral amputation due to peripheral vascular disease

Erjavec

Vidmar

Burger

2013

Disability and Rehabilitation

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At the level of 30 W, the oxygen uptake during the exercise was the closest to the 6 MWT, so we estimated that to be the minimum required level for walking using a prosthesis after transfemoral amputation due to PVD. Implications for Rehabilitation Exercise testing after transfemoral amputation. Walking with a prosthesis causes notable strain to the person's vascular system: after the 6-min walk test, the participants' heart rate reached 75% of the maximum predicted heart rate on average. The study shows that persons after transfemoral amputation due to peripheral vascular disease who reach the level of 30 W or more in exercise testing with an arm ergometer at admission to rehabilitation are likely to be able to walk in-doors using a prosthesis.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Exercise testing as a screening measure for ability to walk with aprosthesis after transfemoral amputation due to peripheral vascular disease

Erjavec

Vidmar

Burger

2013

Disability and Rehabilitation

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“…e.g. 2,3,4,5 Using mainly test protocols based on one-leg cycle ergometry or upper body ergometry, these studies collectively report very low VO2max values compared to predicted values for healthy individuals of the same age and sex. 6 A low level of VO2max for transfemoral amputees (TFA) may be caused by several factors: The VO2max may be systematically underestimated due to the choice of test protocol, i.e.…”

Section: Introductionmentioning

confidence: 98%

Assessment of aerobic capacity and walking economy of unilateral transfemoral amputees

Gjøvaag¹,

Starholm²,

Mirtaheri³

et al. 2014

Prosthetics &Amp; Orthotics International

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Background; Studies of the maximal oxygen uptake (VO2max) of transfemoral amputees (TFA) have mostly used protocols that activate a relatively small muscle mass. Consequently, TFA VO2max may be systematically underestimated, and the validity of these test protocols is questionable.Objectives; 1) Investigate validity and reliability of a VO2max walking protocol. 2) Compare the VO2max of a TFA group to a group of matching controls (CON).Study design; 1) Randomized crossover study; walking vs. running VO2max for the CON group, 2) case-control study; TFA vs. CON group VO2max.Methods; Twelve TFA and CON participants performed a walking VO2max test with increasing treadmill inclinations to voluntary exhaustion. The CON group also completed a running ("gold-standard") VO2max test.Results; Mean (SD) CON group VO2max following walking and running was similar, i.e. 2.99 (0.6) and 3.09 (0.7) L·min -1 , respectively. Mean (SD) TFA walking VO2max was 2.14 (0.8) L·min -1 (compared to CON; p < 0.01). Mean intra-class correlation coefficient (ICC) of repeated VO2 measurements was 0.97, and within-subjects standard deviation (Sw) was 60 mL min -1 . Conclusions;The walk protocol is valid. Walking VO2max of TFA was 40 % lower compared to CON.Reliability of the walking protocol is comparable to other walking protocols. Word count: 200 Clinical relevanceThe design, alignment and materials of prostheses are important for effective ambulation. Cardiorespiratory fitness is, however, also important in this regard, and a low fitness may compromise health and independent living. Hence, TFA with low physical fitness should engage in regular physical activity to improve health, gait capacity and independency.Word count: 50

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“…Vestering et al23 ) similarly found that the combined ergometer test increased the heart rate of lower limb amputees. We found that the heart rate was increased in all our tests indicating that both exercise and addition of weight increases the heart rate.…”

Section: Discussionmentioning

confidence: 92%

The effect of segmental weight of prosthesis on hemodynamic responses and energy expenditure of lower extremity amputees

2017

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[Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme’s amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint. The blood pressure and heart rate of the patients were recorded before and after Six Minute Walk Test (6MWT) and 10 stairs up & down stairs test. Physiological Cost Index was used to calculate the energy expenditure. [Results] Heart rate and energy expenditure increased significantly when without weight and with weight results compared. [Conclusion] We conclude that the segmental weight of the prosthetic limb has a significant effect on the heart rate and energy expenditure but has no effect on the systolic and diastolic blood pressure of lower limb amputees. In order to generalize our results to lower limb amputees, more patients need to be included in future studies.

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Development of an exercise testing protocol for patients with a lower limb amputation: results of a pilot study

Cited by 26 publications

References 13 publications

Exercise testing as a screening measure for ability to walk with aprosthesis after transfemoral amputation due to peripheral vascular disease

Exercise testing as a screening measure for ability to walk with aprosthesis after transfemoral amputation due to peripheral vascular disease

Assessment of aerobic capacity and walking economy of unilateral transfemoral amputees

The effect of segmental weight of prosthesis on hemodynamic responses and energy expenditure of lower extremity amputees

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