Esposito Elizabeth Russell, Rodriguez Kelly M, Ràbago Christopher A, Wilken Jason M
Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX.
J Rehabil Res Dev. 2014;51(8):1287-96. doi: 10.1682/JRRD.2014.06.0141.
Previous literature reports greater metabolic demand of walking following transtibial amputation. However, most research focuses on relatively older, less active, and often dysvascular amputees. Servicemembers with traumatic amputation are typically young, fit, and highly active before and often following surgical amputation of their lower limb. This study compared the metabolic demand of walking in young, active individuals with traumatic unilateral transtibial amputation (TTA) and nondisabled controls. Heart rate (HR), rate of oxygen consumption, and rating of perceived exertion (RPE) were calculated as subjects walked at a self-selected velocity and at five standardized velocities based on leg length. The TTA group completed a Prosthetics Evaluation Questionnaire. Oxygen consumption (p = 0.89), net oxygen consumption (p = 0.32), and RPE (p = 0.14) did not differ between groups. Compared with controls, HR was greater in the TTA group and increased to a greater extent with velocity (p < 0.001). Overall, the TTA group rated their walking abilities as high (mean: 93% out of 100%). This is the first study to report equivalent metabolic demand between persons with amputation and controls walking at the same velocity. These results may reflect the physical fitness of the young servicemembers with traumatic amputations and may serve to guide outcome expectations in the future.
先前的文献报道,经胫截肢后行走的代谢需求更高。然而,大多数研究集中在年龄相对较大、活动较少且往往患有血管疾病的截肢者身上。创伤性截肢的军人通常在下肢手术截肢前后都很年轻、健康且活动频繁。本研究比较了年轻、活跃的单侧创伤性经胫截肢(TTA)患者和非残疾对照者行走时的代谢需求。在受试者以自我选择的速度以及基于腿长的五种标准化速度行走时,计算心率(HR)、耗氧率和主观用力程度分级(RPE)。TTA组完成了一份假肢评估问卷。两组之间的耗氧量(p = 0.89)、净耗氧量(p = 0.32)和RPE(p = 0.14)没有差异。与对照组相比,TTA组的HR更高,并且随着速度增加的幅度更大(p < 0.001)。总体而言,TTA组对其行走能力的评价很高(平均:100分中的93分)。这是第一项报告截肢者和以相同速度行走的对照组之间代谢需求相当的研究。这些结果可能反映了年轻创伤性截肢军人的身体素质,并可能有助于指导未来的结果预期。