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Research Objectives
To assess the feasibility of moderate to high intensity gait training in a person
with TF amputation to improve walking outcomes.
Design
Case study: 3 months of intervention and 1 month follow-up.
Setting
Outpatient Physical Therapy.
Participants
64 year-old female five months post TF amputation. PMH included HTN, PVD, DMII, and
current smoker.
Interventions
The patient attended outpatient PT visits for 3 months (24 visits). The goal for each
visit was to spend 40 minutes at 60-80% of their heart rate-reserved (HRR) in the
context of walking.
Main Outcome Measures
Number of visits the HR goal was achieved, Amputee Mobility Predictor, 10 Meter Walk
Test.
Results
Moderate to high intensity gait training was performed in 19 of the 24 visits. The
average HR goal of at least 60% HRR achieved in 10 of the 19 gait training visits.
When the HR goal was achieved, the intervention was performed for an average of 44.2
(±3.8) minutes. The HR goal was not achieved in 9 visits due to: intervention performed
for less than 40 minutes, average HR was below 60% HRR-15, continuous HR monitoring
not possible due to equipment failure, and pain (unrelated to the intervention). For
5 visits the intervention was not performed due to: elevated BP, prosthetic management,
and monthly assessments. The patient demonstrated an increase in the Amputee Mobility
Predictor AMpro by 6 pts and 9pts, 10 Meter Walk Test (10MWT) self-selected (SS) by
0.11m/s and 0.24m/s, and 10MWT (fast) by 0.1m/s and 0.19 at 1 and 3 months respectively,
after starting the moderate to high intensity training. At one month post training,
the AMpro decreased by 3 pts and 10MWT (SS) by 0.7m/s. There was however an increase
in the 10MWT (fast) 0.12m/s.
Conclusions
Moderate to high-intensity gait training is safe and feasible in a patient with TF
amputation and it improves walking outcomes. There were no adverse reactions to the
intervention. The patient was on multiple medications for BP management that may have
affected HR response making it more difficult to achieve the HR goal.
Author(s) Disclosures
None.
Keywords
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Copyright
© 2022 Published by Elsevier Inc.
