Kurdibaylo S F
Saint Petersburg Scientific Research Institute of Prosthetics, Russia.
J Rehabil Res Dev. 1994 Aug;31(3):222-35.
Two hundred and thirty subjects with various levels of upper and lower limb amputation were examined with regard to cardiac and respiratory functions. The subjects were examined at rest and in balanced wheelchair ergometer testing. Noncontinuous step-by-step increased loading was performed. The data given are for age-group 20-40 who sustained traumatic amputation and suffered no prior respiratory or circulatory disease. Subjects after above-knee (AK), bilateral AK or AK plus below-knee amputation) showed a loss of the reaction of an adequate systolic output rise in wheelchair ergometer testing. In the adults with amputation, the increase of minute stroke volume occurred solely at the expense of heart rate. The contractile capacity of myocardium was decreased. Cardiac indicator value in subjects with AK or bilateral AK amputation in sub-maximal exercises training appeared to be lower than in the control group. A reduced work capacity takes place in subjects after body mass loss. The maximal oxygen intake in subjects with bilateral lower limb amputation was less than in the control group. The breaking of correlation interrelationships between working capacity indicators was revealed in the subjects with bilateral lower limb amputation. The adults with upper limb amputation showed a reduction in pulmonary ventilation. During exercise training, the capacity for adequate pulmonary ventilation was lost in the above-mentioned subjects. This research demonstrates that movement capabilities in adults with amputation depend not on the level of amputation and residual limb condition, but to a great extent upon the dynamic capabilities of the cardiac and respiratory muscular systems' ability to adjust to the limb loss.
对230名不同程度的上肢和下肢截肢患者进行了心脏和呼吸功能检查。这些患者在静息状态下以及在平衡轮椅测力计测试中接受了检查。测试采用非连续逐步增加负荷的方式。给出的数据针对的是年龄在20至40岁之间、因创伤性截肢且既往无呼吸或循环系统疾病的患者。大腿以上截肢(AK)、双侧AK截肢或AK加小腿以下截肢的患者在轮椅测力计测试中显示出适当的收缩期输出量上升反应丧失。在成年截肢患者中,每分心输出量的增加仅以心率增加为代价。心肌收缩能力下降。在次最大运动训练中,AK或双侧AK截肢患者的心脏指标值似乎低于对照组。体重减轻的患者工作能力下降。双侧下肢截肢患者的最大摄氧量低于对照组。双侧下肢截肢患者的工作能力指标之间的相关关系被打破。上肢截肢的成年人肺通气量减少。在运动训练期间,上述患者丧失了适当肺通气的能力。这项研究表明,成年截肢患者的运动能力并不取决于截肢水平和残肢状况,而是在很大程度上取决于心脏和呼吸肌肉系统适应肢体缺失的动态能力。