Physical Fitness of Lower Limb Amputees

Chin, Takaaki; Sawamura, Seishi; Fujita, Hisao; Nakajima, Sakuya; Oyabu, Hiroko; Nagakura, Yuji; Ojima, Iwao; Otsuka, Hiroshi; Nakagawa, Akio

doi:10.1097/00002060-200205000-00001

Cited by 78 publications

(65 citation statements)

References 10 publications

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“…Hence, the TFA participants have considerably lower cardio-respiratory fitness than able-bodied subjects with similar age, height, weight, sex and selfreported fitness. In this regard, it is argued that only those amputees who have adequate fitness will become successful prosthetic users 4 . Consequently, TFA should engage in regular physical activity to reduce the risk of further reductions of their cardio-respiratory fitness and to ensure effective prosthetic ambulation.…”

Section: Validity Of the Walking Protocolmentioning

confidence: 99%

“…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: 99%

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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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Section: Validity Of the Walking Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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“…Concerning aerobic capacity, Chin et al 13 found that the physical fitness of young, traumatic amputees was lower than that of able-bodied subjects. The maximum oxygen uptake (VO 2 max) of the amputee group was 18.8 mL/kg per min (SD 4.9) whereas the VO 2 max of the able-bodied group was 23.5 mL/kg per min (SD 3.2), a statistically significant difference.…”

Section: Status and Development Of Physical Capacitymentioning

confidence: 99%

Physical capacity and walking ability after lower limb amputation: a systematic review

et al. 2006

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Objective: To review the influence of physical capacity on regaining walking ability and the development of walking ability after lower limb amputation. Design: A systematic search of literature was performed. The quality of all relevant studies was evaluated according to a checklist for statistical review of general papers. Subjects: Lower limb amputees. Main measures: Physical capacity (expressed by aerobic capacity, anaerobic capacity, muscle force, flexibility and balance) and walking ability (expressed by the walking velocity and symmetry). Results: A total of 48 studies that complied with the inclusion criteria were selected. From these studies there is strong evidence for deterioration of two aspects of physical capacity (muscle strength and balance) and of two aspects of walking ability (walking velocity and symmetry) after lower limb amputation. Strong evidence was found for a relation between balance and walking ability. Conclusion: Strong evidence was only found for a relation between balance and walking ability. Evidence about a relation between other elements of physical capacity and walking ability was insufficient. Training of physical capacity as well as walking ability during rehabilitation following lower limb amputation should not be discouraged since several parameters have been shown to be reduced after amputation, although their relation to regaining walking ability and to the development of walking ability remains unclear.

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“…Such a strong difference should be observable in our experiments, even at low workloads, if co-contraction, contracture and spasticity are responsible for the increase in energy expenditure. A similar protocol was used by Chin et al [21] to evaluate the fitness of young adult traumatic amputees (mean age: 26.0 AE 5.7 years) pedalling one lower limb at a time with their healthy lower limb. The mean maximal workload that patients could reach was 67.6 AE 20.2 W, whereas healthy subjects could reach 102.4 AE 33.6 W. This low working capacity could also be explained by cardiovascular deconditioning and comorbidities [22], neurological impairments [24], muscular atrophy, decreased lean tissue mass and increased intramuscular-fat in paretic lower limb [23].…”

Section: Working Capacitymentioning

confidence: 99%

Efficiency of work production by spastic muscles

et al. 2005

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Physical Fitness of Lower Limb Amputees

Abstract: This study showed that the physical fitness of amputees was clearly lower than that of the able-bodied subjects and that the amputees were able to recover from a poorly conditioned status after endurance training.

Cited by 78 publications

References 10 publications

Assessment of aerobic capacity and walking economy of unilateral transfemoral amputees

Assessment of aerobic capacity and walking economy of unilateral transfemoral amputees

Physical capacity and walking ability after lower limb amputation: a systematic review

Efficiency of work production by spastic muscles

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