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 phy...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 <right transtibial amputated leg (AL) using a total surface-bearing prosthesis (TSB) and left non-AL> 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.展开更多
目的:系统评价非负重运动锻炼在糖尿病足溃疡病人中应用效果,为糖尿病足运动干预提供循证依据。方法:计算机检索PubMed、the Cochrane Library、EMbase、Web of Science、中国知网、万方数据库收录的关于非负重运动锻炼在糖尿病足溃疡...目的:系统评价非负重运动锻炼在糖尿病足溃疡病人中应用效果,为糖尿病足运动干预提供循证依据。方法:计算机检索PubMed、the Cochrane Library、EMbase、Web of Science、中国知网、万方数据库收录的关于非负重运动锻炼在糖尿病足溃疡病人中应用的随机对照试验,检索时限从建库到2022年8月31日。由2名研究人员进行筛选文献、提取资料和评价文献质量,采用RevMan 5.3软件进行Meta分析。结果:共纳入15篇随机对照试验,涉及1296例糖尿病足病人。Meta分析结果显示,非负重运动锻炼可以改善糖尿病足溃疡病人的伤口愈合率[RR=2.76,95%CI(2.00,3.80),P<0.00001],改善病人的踝肱指数(ABI)[RR=0.07,95%CI(0.04,0.10),P<0.0001];两组运动时不良事件发生率比较,差异无统计学意义[RR=0.76,95%CI(0.54,1.09),P=0.14];非负重运动锻炼对血糖相关指标和生活质量的影响尚不明确。结论:现有证据表明,非负重运动锻炼对糖尿病足溃疡病人有较好的临床结局,可以提高病人的伤口愈合率,改善病人的ABI。但纳入的研究在质量和数量上有所限制,需要更多高质量和大样本的研究对此结论进行验证。展开更多
文摘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 <right transtibial amputated leg (AL) using a total surface-bearing prosthesis (TSB) and left non-AL> 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.
