scholarly journals Feasibility and Validity of a Graded One-Legged Cycle Exercise Test to Determine Peak Aerobic Capacity in Older People With a Lower-Limb Amputation

2012 ◽  
Vol 92 (2) ◽  
pp. 329-338 ◽  
Author(s):  
Daphne Wezenberg ◽  
Arnold de Haan ◽  
Lucas H. van der Woude ◽  
Han Houdijk
Keyword(s):  
Older People ◽  
Aerobic Capacity ◽  
Exercise Test ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Lower Limb Prosthesis ◽  
Valid Assessment ◽  
Peak Aerobic Capacity ◽  
Limb Prosthesis

BackgroundInformation concerning exercise tolerance and aerobic capacity is imperative for generating effective and safe exercise programs. However, for older people with a lower-limb amputation, a standard exercise test is not available.ObjectiveThe primary aim of the present study was to determine whether a graded 1-legged peak exercise test is feasible and provides a valid assessment of peak aerobic capacity in older people walking with a lower-limb prosthesis.DesignThis was a quasi-experimental case-control study.MethodsA total of 36 older people with a lower-limb prosthesis and 21 people who were able-bodied (controls) (overall mean age=61.7 years, SD=6.1) performed a discontinuous graded 1-legged exercise test. The peak respiratory exchange ratio was used as an indicator of maximal effort. The controls performed an additional 2-legged exercise test to provide insight into differences between the testing modes.ResultsAll participants were able to perform the exercise test. Electrocardiographic tracings and blood pressure were adequately monitored. The controls and the people with a lower-limb amputation were able to stress the cardiovascular system to a similar extent. Analyses of construct validity revealed that the peak aerobic capacity measured with the 1-legged exercise test was able to distinguish between participants on the basis of age, body mass index, and sex to a similar extent as the conventional 2-legged exercise test.LimitationsThe results can be generalized only to people who are able to ambulate with their prosthesis.ConclusionsThe graded 1-legged exercise test was feasible and provided a valid assessment of peak aerobic capacity and exercise tolerance in older people walking with a lower-limb prosthesis.

scholarly journals Prosthetics for Lower Limb Amputation

2021 ◽  
Author(s):  
P. Senthil Selvam ◽  
M. Sandhiya ◽  
K. Chandrasekaran ◽  
D. Hepzibah Rubella ◽  
S. Karthikeyan
Keyword(s):  
Gait Analysis ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Complete Picture ◽  
Limb Amputation ◽  
Advantages And Disadvantages ◽  
Diagrammatic Representation ◽  
Mechanical Component ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

The Chapter will include a brief note on Amputation, Particularly Lower Limb Amputation (LLA), Levels and Causes of LLA. Importance of Prosthetics for LLA are explained in detail. The types of Prosthesis, Application (Donning & Doffing) of prosthesis are included in this chapter. Diagrammatic representation of the prosthesis are added too. Bio mechanical component is explained in detail within this chapter. The advantages and disadvantages of each and every Lower limb Prosthesis are clearly mentioned. Moreover, the Gait analysis & Training after the application of prosthesis are discussed. The reader will get a complete picture of Prosthetics for Lower limb Amputation by going through this chapter for lower limb prosthesis.

Group-based telerehabilitation intervention using Wii Fit to improve walking in older adults with lower limb amputation (WiiNWalk): A randomized control trial

2021 ◽  
pp. 026921552110612
Author(s):  
Gordon Tao ◽  
William C. Miller ◽  
Janice J. Eng ◽  
Elham Esfandiari ◽  
Bita Imam ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walk Test ◽  
Balance Confidence ◽  
Wii Fit ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

Objective Determine efficacy of the novel WiiNWalk intervention on walking-related outcomes in older adults with lower limb amputation. Design Multi-site, parallel, evaluator-masked randomized controlled trial. Setting Home-setting in three Canadian cities. Participants Community-dwelling lower limb prosthesis users over 50 years of age. Interventions The WiiNWalk group (n = 38) used modified Wii Fit activities for prosthetic rehabilitation. The attention control group (n = 33) used Big Brain Academy: Wii Degree, comprising of cognitive activities. Both groups completed a 4-week supervised phase with three 1-h sessions/week in groups of three overseen by a clinician via videoconferencing and a 4-week unstructured and unsupervised phase. Main Measures Primary outcome was walking capacity (2 min walk test); secondary outcomes were balance confidence (activities-specific balance confidence scale), dynamic balance (four-step square test), and lower limb functioning (short physical performance battery). Outcomes were compared across time points with repeated measures analysis of covariance, adjusting for baseline and age. Results Mean age was 65.0 (8.4) years, with 179.5 (223.5) months post-amputation and 80% transtibial amputation. No group difference in a 2 min walk test with an effect size: 1.53 95% CI [−3.17, 6.23] m. Activities balance confidence was greater in the WiiNWalk group by 5.53 [2.53, 8.52]%. No group difference in the four-step square test −0.16 [−1.25, 0.92] s, nor short physical performance battery 0.48 [−0.65, 1.61]. A post-hoc analysis showed the greatest difference in balance confidence immediately after an unsupervised phase. Conclusions The WiiNWalk intervention improved balance confidence, but not walking-related physical function in older adult lower limb prosthesis users. Future rehabilitation games should be specific to the amputation context. Clinical Trial Registration number, NCT 01942798.

scholarly journals A low-cost easily implementable physiotherapy intervention clinically improves gait implying better adaptation to lower limb prosthesis: a randomized clinical trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Leticia Vargas Almeida ◽  
Claudiane Arakaki Fukuchi ◽  
Tania Emi Sakanaka ◽  
Alberto Cliquet
Keyword(s):  
Lower Limb ◽  
Low Cost ◽  
Intervention Group ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Control Group ◽  
Post Intervention ◽  
Physiotherapy Intervention ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

AbstractLower limb amputation highly impacts the lives of individuals. The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and easily implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. Participants with amputation were further divided in intervention and control groups. The intervention group underwent a rehabilitation protocol aimed at strengthening muscles and improving prosthesis adaptation. Muscle strengthening targeted the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors and abductors, followed by cicatricial mobilization and weight-bearing on the stump for desensitization. Assessment and measures were performed across the kinetic and kinematic parameters of gait. In the comparison between pre-and post-intervention, a significant increase in gait speed (0.68—2.98, 95% CI, 1.83, effect size ES) and cadence (0.56—2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73—3.11, 95% CI, 1.92, ES) and stride length (0.62—2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased stance phase as a percentage of gait cycle between pre- and post-intervention (− 1.33—0.62, 95% CI, − 36, ES), while it increased in the control group. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. It is recommended that the participants continue receiving follow-up assessments and rehabilitation interventions.

Cardiorespiratory fitness and physical strain during prosthetic rehabilitation after lower limb amputation

2019 ◽  
Vol 43 (4) ◽  
pp. 418-425
Author(s):  
Daphne Wezenberg ◽  
Rienk Dekker ◽  
Frank van Dijk ◽  
Willemijn Faber ◽  
Lucas van der Woude ◽  
...  
Keyword(s):  
Heart Rate ◽  
Cardiorespiratory Fitness ◽  
Aerobic Capacity ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Prosthetic Rehabilitation ◽  
Physical Strain ◽  
Individual Level ◽  
The Individual

Background: Sufficient cardiorespiratory fitness has been regarded a prerequisite for prosthetic walking. In order to improve cardiorespiratory fitness, adequate strain ought to be placed on the system during training. Objectives: To determine cardiorespiratory fitness at the start and end of inpatient rehabilitation after lower limb amputation and determine the physical strain experienced during conventional prosthetic rehabilitation. Study design: Multicenter prospective cohort study. Methods: Cardiorespiratory fitness was assessed using a peak one-legged cycle exercise test. Physical strain was assessed during a minimum of three full rehabilitation days using heart rate recordings. Physical strain was expressed in the time per day that heart rate exceeded 40% of heart rate reserve. Results: At the start of rehabilitation, peak aerobic capacity was on average 16.9 (SD, 6.5) mL/kg/min ( n = 33). Overall, peak aerobic capacity did not improve over the course of rehabilitation ( n = 23, p = 0.464). Fifty percent of the patients experienced a physical strain level that satisfies minimum criteria for maintaining cardiorespiratory fitness (>40% heart rate reserve for 30 min/day). Conclusion: Cardiorespiratory fitness was low and did not increase during conventional prosthetic rehabilitation. On average, the physical strain during rehabilitation was insufficient to elicit potential improvements in aerobic capacity. Results stress the need for dedicated physical training modules at the individual level. Clinical relevance This study shows that clinicians ought to be aware of the relatively low cardiorespiratory fitness of people who have undergone lower limb amputation and that improvements during rehabilitation are not always obtained. Results stress the need for physical training modules in which intensity is imposed at the individual level.

Patient’s satisfaction with a lower limb prosthesis: a longitudinal study

2021 ◽  
Vol 28 (3) ◽  
pp. 276-283
Author(s):  
Isaias Pimentel dos Santos ◽  
Alana das Mercês Silva ◽  
Graziella Santos Furtado ◽  
Rosarly Maria Marques de Menezes ◽  
Kionna Oliveira Bernardes dos Santos ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Lower Limb ◽  
Limb Amputation ◽  
Patient’S Satisfaction ◽  
Lower Limb Prosthesis ◽  
Level Of Significance ◽  
Ambulatory Rehabilitation ◽  
Limb Prosthesis ◽  
Over Time

ABSTRACT This is a descriptive longitudinal study that aimed to verify prosthesis satisfaction of older adults with lower-limb amputation (LLA). In total, This study was composed of 34 older adults with LLA participated of this study. Participant’s satisfaction about the lower-limb prosthesis (LLP), the discomforts, and the embarrassment when use it were evaluated through an interview composed of five questions. The occurrence of falls and the independence in prosthesis management were also evaluated. All variables were collected at the last week of ambulatory rehabilitation discharge and after one and three months. A descriptive and inferential statistical analysis was performed. The level of significance was set at 5% (p <0.05). In total, 80% of participants with transtibial amputation and 78.6% of participants with transfemoral amputation were satisfied with the LLP after three months. Tight prosthesis, walking pain, the embarrassment of using LLP, and the occurrence of falls decreased over time. The independence in prosthesis handling did not change significantly after three months. Participants that used manual locking knee (p=0.040) and/or Solid-Ankle Cushion Heel foot (p=0.017) were more satisfied with LLP. The occurrence of falls reduced (p=0.039) after transfemoral participants started to use the prosthesis. Participant’s satisfaction with the LLP was high and did not change significantly over time.

The mental health problems and needs of older people following lower-limb amputation

2006 ◽  
Vol 16 (2) ◽  
pp. 155-163 ◽  
Author(s):  
Wendy Briggs
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Older People ◽  
Lower Limb ◽  
Mental Health Problems ◽  
Traumatic Injury ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Anecdotal Evidence ◽  
The Past

In the past, most amputees have been veterans of war or other younger people who have sustained traumatic injury. There are now an increasing number of older people undergoing lower-limb amputation, most commonly because of vascular problems. Anecdotal evidence suggests that there is a lack of support for patients facing limb amputation, and a lack of recognition from staff that these patients may be at risk of ongoing psychological problems following the procedure.

Relation Between Aerobic Capacity and Walking Ability in Older Adults With a Lower-Limb Amputation

2013 ◽  
Vol 94 (9) ◽  
pp. 1714-1720 ◽  
Author(s):  
Daphne Wezenberg ◽  
Lucas H. van der Woude ◽  
Willemijn X. Faber ◽  
Arnold de Haan ◽  
Han Houdijk
Keyword(s):  
Older Adults ◽  
Aerobic Capacity ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walking Ability

scholarly journals Research on the Improved CNN Deep Learning Method for Motion Intention Recognition of Dynamic Lower Limb Prosthesis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Qiulin Wang
Keyword(s):  
Deep Learning ◽  
Lower Limb ◽  
Learning Algorithm ◽  
Recognition Rate ◽  
Limb Amputation ◽  
Deep Learning Algorithm ◽  
The Disabled ◽  
Lower Limb Prosthesis ◽  
Movement Intention ◽  
Limb Prosthesis

Objective. In order to study the motion recognition intention of lower limb prosthesis based on the CNN deep learning algorithm. Methods. A convolutional neural network (CNN) model was established to reconstruct the motion pattern. Before the movement mode of the affected side was converted, the sensor was bound to the healthy side. The classifier was employed to extract and classify the features, so as to realize the accurate description of the movement intention of the disabled. Results. The method proposed in this research can achieve 98.2% recognition rate of the movement intention of patients with lower limb amputation under different terrains, and the recognition rate can reach 97% after the pattern converted between the five modes was added. Conclusion. The deep learning algorithm that automatically recognized and extracted features can effectively improve the control performance on the intelligent lower limb prosthesis and realize the natural and seamless conversion of the intelligent prosthesis in a variety of motion modes.

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