Cardiorespiratory fitness in persons with lower limb amputation.
Loeke van Schaik, Ilse J Blokland, Klaske van Kammen and 3 others
PMID 38411014WHAT IT FOUND
People with lower limb amputation in rehabilitation had mean peak oxygen uptake 14.6 mL/kg/min, low compared with age-matched references.
Older age was linked to lower fitness. Cardiopulmonary exercise testing was feasible and may help plan fitness training, but it does not show training improves walking.
Key findings
01Peak oxygen uptake averaged 14.6 ± 4.1 mL/kg/min in the 74 participants analysed.
02Older age was the only significant predictor in the final model, with a regression coefficient of -0.15 and a reported decrease of 1.5 mL/kg/min for every 10 years.
03No participant stopped the test because of cardiovascular events, and four tests were excluded because the participant did not reach maximal effort due to musculoskeletal pain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study used people already referred for cardiopulmonary exercise testing at one rehabilitation centre, so it does not represent all people with lower limb amputation in the Netherlands. Older people with lower limb amputation, who often have more comorbidity, may have gone to nursing home rather than a rehabilitation centre, so the measured fitness could be higher than in the wider population. The sample was small and heterogeneous, with few women and few non-vascular amputations, so the study cannot reliably judge gender or cause of amputation as predictors. The comparison values were taken from able-bodied reference data, not from matched controls tested in the same way during this study. The study measured fitness at one time point and did not test rehabilitation or training, so it cannot show that improving fitness causes better walking or independence.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that cardiopulmonary exercise testing is safe for every person with lower limb amputation. The participants were already referred for testing in a supervised rehabilitation centre, and people who were not referred, including many older people in nursing homes, were not represented.