Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
Prosthet Orthot Int. 2024 Jun 1;48(3):258-266. doi: 10.1097/PXR.0000000000000287. Epub 2023 Sep 14.
Knowledge about the energy expenditure of typical activities of daily living (ADL) in persons with lower limb amputation (LLA) is lacking. This study investigated the following: (1) oxygen consumption per unit distance (V̇O 2 ; mL·kg -1 ·min -1 ), (2) proportion utilization of peak oxygen consumption (%V̇O 2 peak), (3) oxygen cost (energy cost; mL·kg -1 ·m -1 ), and (4) perceived exertion (rating of perceived exertion) of ADL in persons with LLA and able-bodied controls.
Participants (21 with LLA/12 controls) performed 2 household ADL experiments: in-house walking and vacuuming and 3 community ADL experiments: marked shopping, fast walking, and stair negotiation. V̇O 2 peak was assessed with arm crank ergometry, and ambulatory activity was monitored for 7 days with a StepWatch.
Participants with LLA performed in-house walking, marked shopping, vacuuming, and stair negotiation at a similar V̇O 2 as controls, while their self-selected walking speed (WS) was significantly lower. Participants with LLA had significantly higher %V̇O 2 peak than controls during in-house walking and reported a significantly higher rating of perceived exertion for vacuuming and marked shopping. The highest possible WS of participants with LLA during fast walking was significantly lower than that of controls, but V̇O 2 was also significantly lower, indicating a limited capacity to walk at higher WS. Participants with LLA had a significantly lower daily step count, significantly lower-proportion high-intensity ambulation, but significantly higher-proportion low-intensity ambulation than controls, indicating that persons with LLA also walked at lower WS in daily life.
The results indicate that persons with LLA have increased physical and perceived effort during performance of ADL compared with persons without amputation, which has consequences for community participation, and hence independence and quality of life.
下肢截肢（LLA）患者日常活动（ADL）的能量消耗知识尚不清楚。本研究调查了以下内容：（1）单位距离的耗氧量（V̇O 2 ；mL·kg -1 ·min -1 ），（2）最大摄氧量利用率（%V̇O 2 峰值），（3）氧耗（能量消耗；mL·kg -1 ·m -1 ），以及（4）LLA 患者和非截肢对照组 ADL 的感知用力（感知用力等级）。
参与者（LLA 患者 21 人/对照组 12 人）进行了 2 项家庭 ADL 实验：室内步行和吸尘，以及 3 项社区 ADL 实验：标记购物、快速行走和楼梯上下。最大摄氧量通过手臂曲柄测功仪进行评估，7 天内通过 StepWatch 监测日常活动。
LLA 患者进行室内步行、标记购物、吸尘和楼梯上下的 V̇O 2 与对照组相似，而他们的自主选择步行速度（WS）明显较低。与对照组相比，LLA 患者在室内步行时的最大摄氧量利用率明显更高，在吸尘和标记购物时的感知用力等级更高。LLA 患者在快速行走时能达到的最高 WS 明显低于对照组，但 V̇O 2 也明显较低，表明他们在较高 WS 下行走的能力有限。LLA 患者的日常步数明显较少，高强度活动的比例明显较低，但低强度活动的比例明显较高，这表明他们在日常生活中也以较低的 WS 进行行走。
结果表明，与非截肢者相比，LLA 患者在进行 ADL 时需要付出更多的体力和感知上的努力，这对其参与社区活动、独立性和生活质量都有影响。
