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

Disabil Rehabil. 2014;36(14):1148-55. doi: 10.3109/09638288.2013.833307. Epub 2013 Sep 10.

Abstract

Purpose: To establish at which exercise-power level is the vascular response, as measured by oxygen uptake, closest to the response during the 6-min walk test (6 MWT) in people after lower-limb amputation due to peripheral vascular disease (PVD).

Method: A prospective exploratory cohort study was conducted. 6 MWT and exercise testing using a hand-wheel ergometer (starting at 10 W and increasing the workload by 10 W) were performed in 101 consecutively recruited participants after transfemoral amputation due to PVD. Agreement of oxygen uptake during 6 MWT and exercise testing was compared between the groups defined by the exercise-power level reached.

Results: Linear regression through origin with Chow test for comparing slopes indicated that oxygen uptake at 30 W agreed more with 6 MWT than at 20, 40 or 50 W. Analyses of observed differences (one-way ANOVA with post-hoc tests, Jonckheere-Terpstra test) confirmed 30 W to be the recommendable threshold.

Conclusions: 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.

Keywords: Amputation; exercise testing; oxygen uptake; prosthesis; walking.

Publication types

  • Comparative Study

MeSH terms

  • Acceleration
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / methods
  • Amputation, Surgical / rehabilitation*
  • Analysis of Variance
  • Artificial Limbs
  • Cohort Studies
  • Disability Evaluation
  • Ergometry / methods
  • Exercise Test / methods*
  • Female
  • Femur / surgery
  • Heart Rate / physiology
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Oxygen Consumption / physiology*
  • Peripheral Vascular Diseases / diagnosis
  • Peripheral Vascular Diseases / surgery*
  • Prognosis
  • Prospective Studies
  • Prosthesis Fitting / methods
  • Risk Assessment
  • Walking / physiology*