Abstract
Wezenberg D, de Haan A, Faber WX, Slootman HJ, van der Woude LH, Houdijk H. Peak oxygen
consumption in older adults with a lower limb amputation.
Objective
To investigate whether the aerobic capacity of older adults who underwent a lower
limb amputation is associated with the presence, cause (traumatic or vascular), and
level of amputation (transtibial or transfemoral).
Design
Cross-sectional descriptive.
Setting
Human motion laboratory at a rehabilitation center.
Participants
Older subjects (n=36) who underwent lower limb amputation and age-matched, able-bodied
controls (n=21). All subjects were able to walk for a minimum of 4 minutes.
Interventions
Not applicable.
Main Outcome Measure
Peak oxygen consumption (Vo2peak) was measured using open-circuit respirometry while performing a discontinuous, graded,
1-legged, peak cycle exercise test.
Results
After correcting for age, body mass index, and sex, the multiple linear regression
analysis revealed that subjects who underwent amputation had a 13.1% lower aerobic
capacity compared with able-bodied controls (P=.021). Differentiation among etiologies revealed that subjects with a vascular amputation
had a lower Vo2peak of 29.1% compared with able-bodied controls (P<.001), whereas traumatic amputees did not differ from able-bodied controls (P=.127). After correcting for etiology, no association between level of amputation
and Vo2peak was found (P=.534).
Conclusions
Older adults who underwent an amputation because of vascular deficiency had a lower
aerobic capacity compared with able-bodied controls and people with a traumatic amputation.
The level of amputation was not associated with Vo2peak.
Key Words
List of Abbreviations:
BMI (body mass index), ECG (electrocardiogram), HRpeak (peak heart rate), HR%predicted (percentage of the predicted peak heart rate reached), RERpeak (peak respiratory exchange ratio), Vo2peak (peak oxygen consumption)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Predicting walking ability following lower limb amputation: a systematic review of the literature.J Rehabil Med. 2009; 41: 593-603
- Physical capacity and walking ability after lower limb amputation: a systematic review.Clin Rehabil. 2006; 20: 999-1016
- Effect of endurance training program based on anaerobic threshold (AT) for lower limb amputees.J Rehabil Res Dev. 2001; 38: 7-11
- %VO2max as an indicator of prosthetic rehabilitation outcome after dysvascular amputation.Prosthet Orthot Int. 2002; 26: 44-49
- Effect of physical fitness on prosthetic ambulation in elderly amputees.Am J Phys Med Rehabil. 2006; 85: 992-996
- The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue.J Appl Physiol. 2003; 95: 1901-1907
- Maximal aerobic capacity testing of older adults: a critical review.J Gerontol. 2005; 60: 57-66
- The effect of bed rest and potential of prehabilitation on patients in the intensive care unit.AACN Clin Issues. 2002; 13: 263-276
- Claimed walking distance of lower limb amputees.Disabil Rehabil. 2005; 27: 101-104
- Energy cost of walking of amputees: the influence of level of amputation.J Bone Joint Surg Am. 1976; 58: 42-46
- Effect of speed on the energy cost of walking in unilateral traumatic lower limb amputees.Eur J Appl Physiol. 2008; 103: 655-663
- Energy expenditure of trans-tibial amputees during ambulation at self-selected pace.Prosthet Orthot Int. 1994; 18: 84-91
- Energy cost of walking measurements in subjects with lower limb amputations: a comparison study between floor and treadmill test.Gait Posture. 2008; 27: 70-75
- The energy cost for the step-to-step transition in amputee walking.Gait Posture. 2009; 30: 35-40
- The application of exercise testing to the elderly amputee.Can Med Assoc J. 1973; 108: 314-317
- Cardiorespiratory status and movement capabilities in adults with limb amputation.J Rehabil Res Dev. 1994; 31: 222-235
- Maximal oxygen uptake and heart rate in various types of muscular activity.J Appl Physiol. 1961; 16: 977-981
- Feasibility and validity of a graded one-legged cycle exercise test to determine peak aerobic capacity in older people with a lower-limb amputation.Phys Ther. 2012; 92: 329-338
- ACSM position stand: exercise and physical activity for older adults.Med Sci Sports Exerc. 1998; 30: 992-1008
- ACSM's guidelines for exercise testing and prescription.8th ed. Lippincott Williams & Wilkins, Philadelphia2009
- Age-predicted maximal heart rate revisited.J Am Coll Cardiol. 2001; 37: 153-156
- An analysis of age and other factors related to maximal oxygen uptake.J Appl Physiol. 1967; 22: 934-938
- The efficacy of the one-leg cycling test for determining the anaerobic threshold (AT) of lower limb amputees.Prosthet Orthot Int. 1997; 21: 141-146
- Physical fitness of lower limb amputees.Am J Phys Med Rehabil. 2002; 81: 321-325
- Aerobic training exercises for individuals who had amputation of the lower limb.J Bone Joint Surg Am. 1987; 69: 914-921
- The influence of body position on maximal performance in cycling.Eur J Appl Physiol Occup Physiol. 1990; 61: 138-142
- Exercise performance and VO2 kinetics during upright and recumbent high-intensity cycling exercise.Eur J Appl Physiol. 2010; 110: 39-47
- Daily physical activity and heart rate response in people with a unilateral transtibial amputation for vascular disease.Arch Phys Med Rehabil. 2004; 85: 240-244
- Functional outcomes following trauma-related lower-extremity amputation.J Bone Joint Surg Am. 2004; 86: 1636-1645
- Relationship between energy cost, gait speed, vertical displacement of centre of body mass and efficiency of pendulum-like mechanism in unilateral amputee gait.Gait Posture. 2005; 21: 333-340
- Lower extremity amputees with peripheral vascular disease: graded exercise testing and results of prosthetic training.Arch Phys Med Rehabil. 1987; 68: 14-19
- Exercise performance of lower-extremity amputees.Sports Med. 1995; 20: 207-214
Article info
Publication history
Published online: June 08, 2012
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Clinical Trial Registration No.: NL24196.029.08.
Reprints are not available from the author.
In-press corrected proof published online on Jul 28, 2012, at www.archives-pmr.org.
Identification
Copyright
© 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
