DuBow L L, Witt P L, Kadaba M P, Reyes R, Cochran V
Arch Phys Med Rehabil. 1983 Jun;64(6):255-9.
Elderly bilateral below knee (BK) amputees were tested for oxygen consumption (VO2), heart rate (HR) and velocity (V) during ambulation on a 40m walkway and a stationary wheelchair ergometer. Values obtained from amputees were compared to values obtained from a control population of the same age group. On test day 1 bilateral amputees and normal subjects ambulated at their natural pace on a walkway for approximately 5 minutes. On test day 2 each subject propelled a stationary wheelchair ergometer at their natural rate for the same distance that they ambulated. Measurements of VO2 (ml/m/kg), HR (beats/min), and V (m/min) were obtained during both sessions. Results show that the bilateral BK group required significantly more VO2 (ml/m/kg) (123%), had higher HR (26%), and slower V (36%) than the normal group during ambulation. The energy cost in terms of ml/min/kg during ambulation was similar, suggesting that the amputees ambulated at the same power cost as normals but at lower velocities. During wheelchair propulsion the BK group and normal group showed no significant difference in the 2 criteria. Results suggest that wheelchair propulsion is a more energy efficient mode of mobility for elderly bilateral BK amputees than ambulation. Energy cost and heart rate determinations may be valuable in choosing the course of mobility training and recommended activity levels. Cosmetic, psychosocial, and other clinical factors must be considered in prescribing rehabilitation.
对老年双侧膝下截肢者在40米步行道和固定轮椅测力计上行走时的耗氧量（VO2）、心率（HR）和速度（V）进行了测试。将截肢者获得的值与同年龄组对照人群获得的值进行比较。在测试日1，双侧截肢者和正常受试者在步行道上以自然步速行走约5分钟。在测试日2，每个受试者以自然速率推动固定轮椅测力计，推动的距离与他们行走的距离相同。在两个时段均获得了VO2（毫升/米/千克）、HR（次/分钟）和V（米/分钟）的测量值。结果表明，双侧膝下截肢组在行走过程中所需的VO2（毫升/米/千克）显著更多（123%），HR更高（26%），V更慢（36%）。行走过程中以毫升/分钟/千克为单位的能量消耗相似，这表明截肢者以与正常人相同的功率成本行走，但速度更低。在轮椅推进过程中，双侧膝下截肢组和正常组在这两个标准上没有显著差异。结果表明，对于老年双侧膝下截肢者而言，轮椅推进是一种比行走更节能的移动方式。能量消耗和心率测定在选择移动训练方案和推荐活动水平方面可能具有重要价值。在规定康复方案时，必须考虑美观、心理社会和其他临床因素。
