title: Exercise testing as a screening measure for ability to walk with aprosthesis after transfemoral amputation due to peripheral vascular disease.
abstract: OBJECTIVE
  To establish at which exercise-power level is the vascular response, as measured by oxygen uptake, closest to the response during the 6-min walk test (6 MWT) in people after lower-limb amputation due to peripheral vascular disease (PVD).
  
  
  METHODS
  A prospective exploratory cohort study was conducted. 6 MWT and exercise testing using a hand-wheel ergometer (starting at 10 W and increasing the workload by 10 W) were performed in 101 consecutively recruited participants after transfemoral amputation due to PVD. Agreement of oxygen uptake during 6 MWT and exercise testing was compared between the groups defined by the exercise-power level reached.
  
  
  RESULTS
  Linear regression through origin with Chow test for comparing slopes indicated that oxygen uptake at 30 W agreed more with 6 MWT than at 20, 40 or 50 W. Analyses of observed differences (one-way ANOVA with post-hoc tests, Jonckheere-Terpstra test) confirmed 30 W to be the recommendable threshold.
  
  
  CONCLUSIONS
  At the level of 30 W, the oxygen uptake during the exercise was the closest to the 6 MWT, so we estimated that to be the minimum required level for walking using a prosthesis after transfemoral amputation due to PVD. Implications for Rehabilitation Exercise testing after transfemoral amputation. Walking with a prosthesis causes notable strain to the person's vascular system: after the 6-min walk test, the participants' heart rate reached 75% of the maximum predicted heart rate on average. The study shows that persons after transfemoral amputation due to peripheral vascular disease who reach the level of 30 W or more in exercise testing with an arm ergometer at admission to rehabilitation are likely to be able to walk in-doors using a prosthesis.
authors.affiliation: University Rehabilitation Institute, Republic of Slovenia , Ljubljana , Slovenia and.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Erjavec
authors.forename: Gaj
authors.initials: G
authors.lastname: Vidmar
authors.forename: Helena
authors.initials: H
authors.lastname: Burger
mesh_terms: D000054:Acceleration; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D000704:Analysis of Variance; D001186:Artificial Limbs; D015331:Cohort Studies; D004185:Disability Evaluation; D016552:Ergometry / Q000379:methods; D005080:Exercise Test / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D017755:Prosthesis Fitting / Q000379:methods; D018570:Risk Assessment; D016138:Walking / Q000502:physiology*
keywords: Amputation; exercise testing; oxygen uptake; prosthesis; walking