%VO2max as an indicator of prosthetic rehabilitation outcome after dysvascular amputation

Abstract

In this study, independent ambulation of at least 100 metres with/without a cane was regarded as successful prosthetic rehabilitation. The subjects were classified into two groups according to this criterion at the time of discharge. The successful group attained this performance, the other group failed to reach this level. The successful group included 8 unilateral trans-femoral amputees aged 72.2 +/- 2.1 years who underwent amputation at more than 70 years, and succeeded in walking with a prosthesis. The group which failed included 9 unilateral trans-femoral amputees aged 63.2 +/- 2.1 years who underwent amputation between the ages of 60-65 years, and had great difficulty in walking with a prosthesis. The purpose of this research was to investigate whether or not %VO2max as an indicator of physical fitness is useful in predicting prosthetic rehabilitation outcome after dysvascular amputation by comparing these two groups. Evaluation of physical fitness was conducted before the subjects began prosthetic rehabilitation. Information about each subject before fitting with a prosthesis was collected retrospectively from clinical charts made during admission. The successful group were capable of strenuous exercise, reaching the intensity of 50% VO2max or more. In the group which failed only one reached the intensity of 50% VO2max. The working capacity of 50% VO2max or greater would appear to be a valid initial guideline level of physical fitness at which an amputee can expect to succeed in walking with a prosthesis. Apart from physical fitness, a lesser number of comorbidity, good ability to stand on the remaining leg, and a strong will to walk were found to be important factors contributing to successful prosthetic rehabilitation. This study also showed that age alone was not an important factor.

Assessment of gait stability, harmony, and symmetry in subjects with lower-limb amputation evaluated by trunk accelerations

“…This commonly implies slower and less efficient walking in subjects with amputation than in healthy subjects (HSs) [3][4]. Thus, walking speed (WS) and oxygen consumption have been widely used as indicators of gait ability and to assess rehabilitation outcomes or prosthetic components [5][6][7][8]. Conversely, little attention has been given to upright gait stability in the population with amputation [1,4,9] and even less to gait harmony.…”

The Threshold of Physical Fitness in terms of Maximum Oxygen Uptake as a Predictive Factor for Achieving Prosthetic Walking in Elderly with Unilateral Trans-femoral Amputation or Hip Disarticulation

“…29 We previously reported that 50~60% VO 2max can be regarded as a guideline for the physical fitness level required for successful prosthetic rehabilitation in older lower limb amputees. 20,25 However our previous research did not identify the specific value of physical fitness. By choosing an optimal cut-off value of 53.9%, sensitivity was calculated as 79%, and specificity, 92%.…”

“…No significant difference was observed between the two groups in age, sex and the level of amputation. 17,20,24 and physical fitness 20,25 as important factors related to successful prosthetic rehabilitation. Our results were in agreement with previous reports in many respects.…”

Energy consumption during prosthetic walking and physical fitness in older hip disarticulation amputees

“…The %VO 2 max value for the five who continued to use their prostheses after discharge ranged from 55.8 to 72.0. We have previously reported that %VO 2 max value of 50 to 60 is a valid guideline for the physical fitness required for elderly transfemoral amputees to walk independently [15][16]. Of the elderly transfemoral amputees with %VO 2 max values more than 50, 93.7 percent (30/32) were able to walk independently [16].…”

“…To our knowledge, besides our previous research, no other research specified the level of fitness needed for walking with a prosthesis. Our previous research demonstrated that the maximum oxygen uptake during exercise as a proportion of predicted maximum oxygen uptake (%VO 2 max) value of 50 to 60 is a valid level of fitness required for an older transfemoral patient to walk with a prosthesis [15][16].…”