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Physical capacity and walking ability after lower limb amputation: a systematic review

Heliomare Research and Development, Wijk aan Zee, Amsterdam, The Netherlands, j.van.velzen{at}heliomare.nl

C AM van Bennekom

Heliomare Research and Development and Heliomare Rehabilitation Centre, Wijk aan Zee, Amsterdam, The Netherlands

W Polomski

Heliomare, Rehabilitation Centre, Wijk aan Zee, Amsterdam, The Netherlands

J R Slootman

Heliomare, Rehabilitation Centre, Wijk aan Zee, Amsterdam, The Netherlands

L HV van der Woude

Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit and Rehabilitation Centre Amsterdam, Amsterdam, The Netherlands

H Houdijk

Heliomare Research and Development, Wijk aan Zee and Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands

Objective: To review the influence of physical capacity on regaining walking ability and the development of walking ability after lower limb amputation.

Design: A systematic search of literature was performed. The quality of all relevant studies was evaluated according to a checklist for statistical review of general papers.

Subjects: Lower limb amputees.

Main measures: Physical capacity (expressed by aerobic capacity, anaerobic capacity, muscle force, flexibility and balance) and walking ability (expressed by the walking velocity and symmetry).

Results: A total of 48 studies that complied with the inclusion criteria were selected. From these studies there is strong evidence for deterioration of two aspects of physical capacity (muscle strength and balance) and of two aspects of walking ability (walking velocity and symmetry) after lower limb amputation. Strong evidence was found for a relation between balance and walking ability.

Conclusion: Strong evidence was only found for a relation between balance and walking ability. Evidence about a relation between other elements of physical capacity and walking ability was insufficient. Training of physical capacity as well as walking ability during rehabilitation following lower limb amputation should not be discouraged since several parameters have been shown to be reduced after amputation, although their relation to regaining walking ability and to the development of walking ability remains unclear.

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