Department of Physical Therapy, Philadelphia College of Osteopathic Medicine, 625 Old Peachtree Rd NW, Suwanee, GA 30024 (USA).
Northside Hospital Cancer Institute, Atlanta, Georgia.
Phys Ther. 2019 Mar 1;99(3):258-265. doi: 10.1093/ptj/pzy147.
High-level lower extremity amputation (HLLEA) has significant impact on an individual's ability to ambulate and maintain cardiovascular fitness for extended periods of time.
The purpose of this study was to evaluate whether body weight support (BWS) would improve energy efficiency in an individual with HLLEA to achieve appropriate target cardiovascular intensity for aerobic training.
This was an exploratory single-subject study.
The participant was a 45-year-old woman, 4.5 years after left hip disarticulation secondary to necrotizing fasciitis with resultant organ failure and cardiomyopathy. She was wearing a well-fitted prosthesis and had a goal of ambulating in the community with less fatigue. Vital signs and expiratory gases were recorded, and oxygen uptake efficiency slope was calculated during treadmill walking at 0%, 20%, and 40% unweighting. An age-matched control completed 0% unweighting baseline testing.
Under all conditions of treadmill walking, the participant's heart rate, blood pressure, and rate of perceived exertion consistently increased as speed and time increased. The participant's oxygen uptake efficiency slope was most efficient at 20% unweighting, and the economy of movement improved as the percentage of BWS increased, bringing values closer to the age-matched control. The participant reported only minimal pain immediately following 20% unweighting.
The primary limitation of this study is generalizability of findings because of minimal information for comparing the effects of BWS on aerobic capacity in individuals with HLLEA. Additionally, the percentages of unweighting using BWS were extrapolated based on corollary preexisting research; thus, there were no set parameters defined for this specific population.
BWS allowed the participant to work more efficiently, which suggests that if used during an intervention, BWS might enable individuals with HLLEA to achieve recommended levels of training for aerobic conditioning. In future studies, it is recommended that 20% BWS be used at a speed that results in moderate-intensity exercise for individuals with HLLEA as determined by 50% to 70% of maximum heart rate for 20 to 30 minutes.
高位下肢截肢（HLLEA）对个体的步行能力和长时间保持心血管健康有重大影响。
本研究旨在评估身体重量支持（BWS）是否能提高 HLLEA 个体的能量效率，以达到有氧运动训练的适当目标心血管强度。
这是一项探索性的单例研究。
参与者是一名 45 岁女性，4.5 年前因坏死性筋膜炎导致左髋关节离断，随后出现器官衰竭和心肌病。她戴着一副合适的假肢，目标是在社区中行走时减少疲劳。在跑步机上行走时，记录生命体征和呼气气体，并计算 0%、20%和 40%减重时的耗氧量效率斜率。一名年龄匹配的对照者完成了 0%减重的基线测试。
在所有跑步机行走条件下，随着速度和时间的增加，参与者的心率、血压和感觉用力程度持续增加。参与者的耗氧量效率斜率在 20%减重时最有效，随着 BWS 百分比的增加，运动的经济性得到改善，接近年龄匹配的对照者。参与者在接受 20%减重后立即报告只有轻微疼痛。
本研究的主要局限性是发现的普遍性，因为缺乏比较 HLLEA 个体使用 BWS 对有氧运动能力影响的信息。此外，BWS 的减重百分比是根据先前的相关研究推断出来的；因此，没有为这一特定人群定义具体的参数。
BWS 使参与者能够更有效地工作，这表明如果在干预中使用，BWS 可能使 HLLEA 个体能够达到有氧运动的推荐训练水平。在未来的研究中，建议将 20%的 BWS 用于以中等强度运动的速度，这是通过 50%至 70%的最大心率为 20 至 30 分钟来确定的。
