scholarly journals Quantifying Step Count and Oxygen Consumption with Portable Technology during the 2-Min Walk Test in People with Lower Limb Amputation

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2080
Author(s):  
John D. Smith ◽  
Gary Guerra
Keyword(s):  
Oxygen Consumption ◽  
Lower Limb ◽  
Limb Amputation ◽  
Moderate Intensity ◽  
Walk Test ◽  
Activity Monitors ◽  
Step Counts ◽  
Oxygen Analyzer ◽  
Steady State Activity ◽  
Determine Step

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit®3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. The StepWatch on the ankle (SA) and the vivofit3 on the wrist (VW) had the least error and best accuracy of the activity monitors studied. While there were no significant differences in distance walked, oxygen consumption (VO2) or heart rate (HR) between sexes or level of amputation (p > 0.05), females took significantly more steps than males (p = 0.034), and those with unilateral transfemoral amputations took significantly fewer steps than those with unilateral transtibial amputations (p = 0.023). The VW and SA provided the most accurate step counts among the activity monitors and were not significantly different than hand counts. Oxygen consumption for all participants during the 2MWT was 8.9 ± 2.9 mL/kg/min, which is lower than moderate-intensity activity. While some may argue that steady-state activity has not yet been reached in the 2MWT, it may also be possible participants are not walking as fast as they can, thereby misclassifying their performance to a lower standard.

scholarly journals The L Test of Functional Mobility: Measurement Properties of a Modified Version of the Timed “Up & Go” Test Designed for People With Lower-Limb Amputations

2005 ◽  
Vol 85 (7) ◽  
pp. 626-635 ◽  
Author(s):  
A Barry Deathe ◽  
William C Miller
Keyword(s):  
Test Data ◽  
Lower Limb ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Functional Mobility ◽  
Self Report ◽  
Measurement Properties ◽  
Limb Amputation ◽  
Walk Test ◽  
Walk Tests

AbstractBackground and Purpose. Walk tests provide essential outcome information when assessing ambulation of individuals with lower-limb amputation and a prosthetic device. Existing tests have limitations such as ceiling effects or insufficient challenge. The objective of this study was to assess the reliability and validity of data for a clinical measure of basic mobility, the L Test of Functional Mobility (L Test). Subjects. For this methodological study, 93 people with unilateral amputations (74% transtibial, 26% transfemoral; 78% male, 22% female; mean age=55.9 years) were consecutively recruited from an outpatient clinic. Twenty-seven subjects returned for retesting. Methods. To assess concurrent validity, subjects completed the L Test, Timed “Up & Go” Test (TUG), 10-Meter Walk Test, and 2-Minute Walk Test, followed by the Activities-specific Balance Confidence scale, Frenchay Activities Index (FAI), and mobility subscale of the Prosthetic Evaluation Questionnaire (PEQ-MS). Amputation cause and level, walking aid use, automatic stepping, and age variables were used to assess discriminant validity. Results. Intraclass correlation coefficients were .96 for interrater reliability and .97 for intrarater reliability, and minimal bias existed upon retesting. The magnitude of concurrent validity correlations (r) was very high between the L Test data and data for other walk tests and fair to moderate between the L Test data and data for self-report measures. The L Test discriminated between all groups as hypothesized. Discussion and Conclusion. The L Test is a 20-m test of basic mobility skills that includes 2 transfers and 4 turns. It demonstrated excellent measurement properties in this study.

Peak Oxygen Consumption in Older Adults With a Lower Limb Amputation

2012 ◽  
Vol 93 (11) ◽  
pp. 1924-1929 ◽  
Author(s):  
Daphne Wezenberg ◽  
Arnold de Haan ◽  
Willemijn X. Faber ◽  
Hans J. Slootman ◽  
Lucas H. van der Woude ◽  
...  
Keyword(s):  
Older Adults ◽  
Oxygen Consumption ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Peak Oxygen Consumption ◽  
Limb Amputation

scholarly journals Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge

2016 ◽  
Vol 96 (7) ◽  
pp. 985-994 ◽  
Author(s):  
Caroline E. Roffman ◽  
John Buchanan ◽  
Garry T. Allison
Keyword(s):  
Lower Limb ◽  
Clinical Utility ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Lower Limb Amputation ◽  
Step Test ◽  
Limb Amputation ◽  
Locomotor Performance ◽  
Walk Test ◽  
Four Square

AbstractBackgroundIt is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use.ObjectiveThe purpose of this study was to determine whether different tests of locomotor performance during rehabilitation were associated with significantly greater risk of prosthetic abandonment at 12 months postdischarge.DesignThis was a retrospective cohort study.MethodData for descriptive variables and locomotor tests (ie, 10-Meter Walk Test [10MWT], Timed “Up & Go” Test [TUGT], Six-Minute Walk Test [6MWT], and Four Square Step Test [FSST]) were abstracted from the medical records of 201 consecutive participants with lower limb amputation. Participants were interviewed and classified as prosthetic users or nonusers at 12 months postdischarge. The Mann-Whitney U test was used to analyze whether there were differences in locomotor performance. Receiver operating characteristic curves were generated to determine performance thresholds, and relative risk (RR) was calculated for nonuse.ResultsAt 12 months postdischarge, 18% (n=36) of the participants had become prosthetic nonusers. Performance thresholds, area under the curve (AUC), and RR of nonuse (95% confidence intervals [CI]) were: for the 10MWT, if walking speed was ≤0.44 ms−1 (AUC=0.743), RR of nonuse=2.76 (95% CI=1.83, 3.79; P<.0001); for the TUGT, if time was ≥21.4 seconds (AUC=0.796), RR of nonuse=3.17 (95% CI=2.17, 4.14; P<.0001); for the 6MWT, if distance was ≤191 m (AUC=0.788), RR of nonuse=2.84, (95% CI=2.05, 3.48; P<.0001); and for the FSST, if time was ≥36.6 seconds (AUC=0.762), RR of nonuse=2.76 (95% CI=1.99, 3.39; P<.0001).LimitationsMissing data, potential recall bias, and assessment times that varied were limitations of the study.ConclusionsLocomotor performance during rehabilitation may predict future risk of prosthetic nonuse. It may be implied that the 10MWT has the greatest clinical utility as a single screening tool for prosthetic nonuse, given the highest proportion of participants were able to perform this test early in rehabilitation. However, as locomotor skills improve, other tests (in particular, the 6MWT) have specific clinical utility. To fully enable implementation of these locomotor criteria for prosthetic nonuse into clinical practice, validation is warranted.

scholarly journals Impairment Variables Predicting Activity Limitation in Individuals with Lower Limb Amputation

2010 ◽  
Vol 34 (1) ◽  
pp. 73-84 ◽  
Author(s):  
Michele A. Raya ◽  
Robert S. Gailey ◽  
Ira M. Fiebert ◽  
Kathyrn E. Roach
Keyword(s):  
Muscle Strength ◽  
Lower Limb ◽  
Activity Limitation ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Outcome Variable ◽  
Walk Test ◽  
Personal Factors ◽  
Six Minute Walk Test ◽  
Minute Walk

The purpose of this study was to determine whether measures of impairment (i.e., muscle strength, balance), personal factors (i.e., comorbidities, demographic information) and amputation specific variables (i.e., time since amputation, cause of amputation, level of amputation) were able to predict performance on the six-minute walk test, a measure of activity limitation, in individuals with lower limb amputation. A total of 72 individuals with lower limb amputation ranging in age from 21–83 were tested for balance, limb muscle strength and function. Medical comorbidities were recorded and activity limitation was measured using the six-minute walk test. Data were analyzed and multivariate relationships were examined using multiple linear regression. Impairment variables of strength, balance, subject demographics, time since amputation, cause of amputation and level of amputation were all significant predictors and explained 72% of the variance in the outcome variable. Strength of the hip extensors was the strongest predictor, accounting for 30.9% of the total variance. Multiple factors impact six minute walk scores in individuals with lower limb amputation. Impairments in hip strength and balance appear to be the two most significant. The findings of this study support the use of the six-minute walk test to underscore impairments of the musculoskeletal system that can affect ambulation ability in the amputee.

scholarly journals Explaining modified 2-min walk test outcomes in male Veterans with traumatic or nontraumatic lower-limb amputation

2016 ◽  
Vol 53 (6) ◽  
pp. 1035-1044 ◽  
Author(s):  
Brian J. Loyd ◽  
Thomas T. Fields ◽  
Ryan O. Stephenson ◽  
Jennifer Stevens-Lapsley ◽  
Cory L. Christiansen
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walk Test ◽  
Male Veterans ◽  
Test Outcomes

scholarly journals Daily Step Counts in Service Members with Lower Limb Amputation

2018 ◽  
Vol 50 (5S) ◽  
pp. 391-392
Author(s):  
Elizabeth Russell Esposito ◽  
Barri L. Schnall ◽  
Bradford D. Hendershot ◽  
Jason M. Wilken
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Service Members ◽  
Limb Amputation ◽  
Daily Step ◽  
Step Counts

The 2-minute walk test as a measure of functional improvement in persons with lower limb amputation

2001 ◽  
Vol 82 (10) ◽  
pp. 1478-1483 ◽  
Author(s):  
Dina Brooks ◽  
Janet Parsons ◽  
Judith P. Hunter ◽  
Michael Devlin ◽  
Janice Walker
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Functional Improvement ◽  
Limb Amputation ◽  
Walk Test ◽  
Minute Walk

A randomized controlled trial to evaluate the feasibility of the Wii Fit for improving walking in older adults with lower limb amputation

2016 ◽  
Vol 31 (1) ◽  
pp. 82-92 ◽  
Author(s):  
Bita Imam ◽  
William C Miller ◽  
Heather Finlayson ◽  
Janice J Eng ◽  
Tal Jarus
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walk Test ◽  
Wii Fit ◽  
Randomized Controlled ◽  
End Of Treatment ◽  
Perceived Benefit ◽  
Walking Capacity ◽  
Minute Walk

Objective: To assess the feasibility of Wii.n.Walk for improving walking capacity in older adults with lower limb amputation. Design: A parallel, evaluator-blind randomized controlled feasibility trial. Setting: Community-living. Participants: Individuals who were ⩾50 years old with a unilateral lower limb amputation. Intervention: Wii.n.Walk consisted of Wii Fit training, 3x/week (40 minute sessions), for 4 weeks. Training started in the clinic in groups of 3 and graduated to unsupervised home training. Control group were trained using cognitive games. Main Measures: Feasibility indicators: trial process (recruitment, retention, participants’ perceived benefit from the Wii.n.Walk intervention measured by exit questionnaire), resources (adherence), management (participant processing, blinding), and treatment (adverse event, and Cohen’s d effect size and variance). Primary clinical outcome: walking capacity measured using the 2 Minute Walk Test at baseline, end of treatment, and 3-week retention. Results: Of 28 randomized participants, 24 completed the trial (12/arm). Median (range) age was 62.0 (50-78) years. Mean (SD) score for perceived benefit from the Wii.n.Walk intervention was 38.9/45 (6.8). Adherence was 83.4%. The effect sizes for the 2 Minute Walk Test were 0.5 (end of treatment) and 0.6 (3-week retention) based on intention to treat with imputed data; and 0.9 (end of treatment) and 1.2 (3-week retention) based on per protocol analysis. The required sample size for a future larger RCT was deemed to be 72 (36 per arm). Conclusions: The results suggested the feasibility of the Wii.n.Walk with a medium effect size for improving walking capacity. Future larger randomized controlled trials investigating efficacy are warranted.

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