Energy expenditure during typical household and community activities of daily living in persons with lower limb amputation: A pilot study

Abstract

Introduction: Knowledge about the energy expenditure of typical activities of daily living (ADL) in persons with lower limb amputation (LLA) is lacking. This study investigated the following: (1) oxygen consumption per unit distance (V̇O2; mL·kg−1·min−1), (2) proportion utilization of peak oxygen consumption (%V̇O2peak), (3) oxygen cost (energy cost; mL·kg−1·m−1), and (4) perceived exertion (rating of perceived exertion) of ADL in persons with LLA and able-bodied controls. Methods: Participants (21 with LLA/12 controls) performed 2 household ADL experiments: in-house walking and vacuuming and 3 community ADL experiments: marked shopping, fast walking, and stair negotiation. V̇O2peak was assessed with arm crank ergometry, and ambulatory activity was monitored for 7 days with a StepWatch. Results: Participants with LLA performed in-house walking, marked shopping, vacuuming, and stair negotiation at a similar V̇O2 as controls, while their self-selected walking speed (WS) was significantly lower. Participants with LLA had significantly higher %V̇O2peak than controls during in-house walking and reported a significantly higher rating of perceived exertion for vacuuming and marked shopping. The highest possible WS of participants with LLA during fast walking was significantly lower than that of controls, but V̇O2 was also significantly lower, indicating a limited capacity to walk at higher WS. Participants with LLA had a significantly lower daily step count, significantly lower-proportion high-intensity ambulation, but significantly higher-proportion low-intensity ambulation than controls, indicating that persons with LLA also walked at lower WS in daily life. Conclusions: The results indicate that persons with LLA have increased physical and perceived effort during performance of ADL compared with persons without amputation, which has consequences for community participation, and hence independence and quality of life.