Abstract

Recent studies indicate that persons with dysvascular amputation also have moderate to severe cardiovascular disease with impairment in functional capacity. This may limit the ability to achieve optimal function with their prosthesis because of inadequate conditioning. We developed an exercise testing and training program using arm ergometry in conjunction with standard rehabilitation for persons with acute dysvascular amputation who were profoundly deconditioned after complicated perioperative courses. The program consisted of daily arm ergometry, performed on an interval basis, at an intensity individually optimized through exercise testing. 25 patients, mean age 63 y, completed the inpatient program with pretest and discharge work performance assessment. There was no significant difference between pretest and discharge assessment of baseline or peak heart rate, systolic blood pressure, diastolic blood pressure, or ratings of perceived exertion. Peak systolic blood pressure was elevated at discharge compared to admission testing. Heart rate responses were decreased during early stages of testing when comparing discharge telemetry to admission findings. The duration of exercise increased from 12.6 to 16.3 min, and the maximum work output increased from 17.1 to 23.5 watts. There was no significant morbidity associated with either arm ergometry testing or exercise. We conclude that arm ergometry testing and training is an effective method for improving the efficiency of arm work in patients with acute dysvascular amputation. Verf.-Ref.