TITLE:
Voluntary Thigh Muscle Strength with Resection Stump-Dependent Blood Flow and Vasodilation in an Amputated Lower Leg with Total Surface Bearing Prosthesis during Dynamic Knee Extensor: A Case Trial
AUTHORS:
Takuya Osada, Masahiro Ishiyama, Ryuichi Ueno
KEYWORDS:
Exercising Leg Blood Flow, Vasodilation, Transtibial Amputation, Total Surface Bearing Prosthesis, Doppler Ultrasound
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.7 No.4,
November
15,
2019
ABSTRACT: Background: The magnitude of the hyperemic response due to repeated thigh stump
exercise on incremental contraction intensity might be useful information in
localized exercise tolerance for devising cardiovascular physical therapy for
amputees. The effect of exercise on amputated leg blood flow (LBF) may
potentially be altered due to voluntary muscle contractions after loss of the
lower leg compared with the healthy leg. Case Presentation: A 57-year-old male patient with Burger disease attempted 3 min unilateral
repeat/dynamic knee extensor exercise at a target muscle contraction frequency
(1 s thigh muscle contraction and 1 s relaxation, 90 repetitions) with each leg
at six different contraction intensities
(rubber resistance belt). Simultaneous measurement of blood velocity/flow
(Doppler ultrasound) in the femoral artery, blood pressure, leg vascular
conductance (LVC), and peak muscle strength (PMS) were performed during the 3 min
exercise period. The maximum voluntary contraction by one-legged isometric knee
muscle contraction was 14.7 kg in non-AL and 7.9 kg in the
AL with prosthesis. The relative PMS was defined as “PMS/maximum voluntary
contraction × 100 (%)”. Pre-exercise LBF was lower in the AL (200 ± 25 ml/min)
than the non-AL (275 ± 74 ml/min). Both the non-AL and AL showed good positive
linear relationships between absolute-/relative-PMS and LBF or LVC during 30 s
at steady-state before the end of the exercise period. Furthermore, there was
also similarity seen in the increase rate in LBF and/or LVC for the incremental
relative PMS compared with the absolute PMS. Conclusion: In this case, the muscle strength depended on blood flow increase/vasodilation
was seen in this “AL” using a TSB prosthesis for repeated dynamic knee extensor
exercise. The present amputee’s limb muscle strengthening with the resection
stump closely related to the degree of hyperemia in the amputated limb.