Department of Physical Therapy, University of Illinois at Chicago, Chicago, Illinois, USA.
Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, Illinois, USA.
PM R. 2022 Apr;14(4):445-451. doi: 10.1002/pmrj.12606. Epub 2021 Jun 9.
Lower-limb amputees have increased metabolic costs during walking that may be mitigated by maintaining quadriceps strength and power following amputation. However, there are no current studies investigating the relationship between thigh strength and walking performance in individuals with transfemoral amputation.
To quantify the relationship between intact limb quadriceps strength in transfemoral amputees and six-minute walk test (6MWT) performance.
Descriptive laboratory study.
Laboratory.
Eleven participants with unilateral transfemoral amputations from trauma or osteosarcoma (4 women/7 men, 46.21 ± 12.68 years old, 28.24 ± 20.57 years following amputation).
Strength and power testing on the intact limb followed by 6MWT with a flowmeter to measure oxygen uptake (VO ).
Strength included mass-normalized peak torque, average torque, and average power. 6MWT measures included total distance traveled and VO normalized to distance and mass. Significant correlations (P ≤ .05) were retained for a regression analysis.
Peak isokinetic knee extensor torque was correlated with total VO (r = -.60, P = .05) and distance traveled (r = .84, P = .001). Average isokinetic knee extensor torque was correlated with total VO (r = -.61, P = .046) and distance traveled (r = .85, P = .001). Average knee extensor power was correlated with total VO (r = -.67, P = .026) and distance traveled (r = .88, P < .001). Peak isometric knee extensor torque was correlated with distance traveled (r = .69, P = .019). Average power explained 77.2% of the variance in distance traveled during the 6MWT (P < .001) and average power explained 44.2% of the variance in total VO during the 6MWT (P = .026).
Knee extensor strength was correlated with performance on the 6MWT in individuals with unilateral transfemoral amputation. The strongest relationship was between isokinetic quadriceps power and distance traveled, which suggests that developing quadriceps power in the intact limb following amputation may be an important factor to reduce metabolic cost of walking and support a return to an active lifestyle.
下肢截肢患者在行走时代谢成本增加，这种增加可能通过维持截肢后的股四头肌力量和功率得到缓解。然而，目前尚无研究调查股骨截肢患者健全肢体股四头肌力量与六分钟步行测试（6MWT）表现之间的关系。
定量分析股骨截肢患者健全肢体股四头肌力量与 6MWT 表现之间的关系。
描述性实验室研究。
实验室。
11 名单侧股骨截肢患者，致伤原因包括创伤或骨肉瘤（4 名女性/7 名男性，46.21±12.68 岁，截肢后 28.24±20.57 年）。
在健全肢体上进行力量和功率测试，然后使用气体流量计进行 6MWT，以测量耗氧量（VO ）。
力量包括质量归一化峰值扭矩、平均扭矩和平均功率。6MWT 测量包括总行进距离和 VO 与距离和质量归一化的距离。保留具有统计学意义的相关性（P≤.05）进行回归分析。
等速膝关节伸肌峰值扭矩与总 VO （r=-0.60，P=.05）和行进距离（r=-0.84，P=.001）呈正相关。等速膝关节伸肌平均扭矩与总 VO （r=-0.61，P=.046）和行进距离（r=-0.85，P=.001）呈正相关。平均膝关节伸肌功率与总 VO （r=-0.67，P=.026）和行进距离（r=-0.88，P<.001）呈正相关。等长膝关节伸肌峰值扭矩与行进距离（r=-0.69，P=.019）呈正相关。平均功率解释了 6MWT 中行进距离变化的 77.2%（P<.001），平均功率解释了 6MWT 中总 VO 变化的 44.2%（P=.026）。
单侧股骨截肢患者膝关节伸肌力量与 6MWT 表现相关。等速股四头肌力量与行进距离的相关性最强，这表明在截肢后增强健全肢体股四头肌力量可能是降低行走代谢成本和支持积极生活方式的重要因素。
