Interobserver and intraobserver reliabilities of determining the ventilatory thresholds in subjects with a lower limb amputation and able-bodied subjects during a peak exercise test on the combined arm-leg (Cruiser) ergometer.
Elisabeth K Simmelink, Pieter U Dijkstra, Matthijs C de Bruijn and 4 others
PMID 35763453WHAT IT FOUND
Determining the first ventilatory threshold on a combined arm-leg ergometer is reliable enough for group-level exercise prescription but not for individual cases.
The second threshold was often impossible to identify, making it unreliable for clinical use.
Key findings
01Reliability coefficients for the first ventilatory threshold were between 0.75 and 0.89, which is above the minimum required for research but below the 0.9 needed for safe individual clinical application.
02The second ventilatory threshold could not be determined in a significant number of observations, particularly for the less experienced observer, limiting its reliability.
03Oxygen uptake and heart rate at both thresholds were significantly lower in subjects with lower limb amputation compared to able-bodied subjects.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size of persons with lower limb amputation was small (n=17). There was a significant age difference between the amputation group (mean 54.5 years) and the able-bodied group (mean 37.0 years), which may have influenced the physiological results. The test protocols differed between the two groups (e.g., warm-up duration and workload increments). Test-retest reliability was not investigated because the data did not include repeated tests under the same circumstances. Power output (Watts) could not be linked to the thresholds because the ergometer software was not integrated with the metabolic cart. The amputation group was predominantly traumatic amputations, whereas vascular causes are more common in the general population.
Declared interests
There are no conflicts of interest.
The easy way to misread this
Do not use the determination of VT2 to prescribe exercise intensity for individual patients with lower limb amputation, as it was frequently undeterminable and the reliability analysis was limited by missing data.