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Hussain, M.A., Al-Omran, M., Salata, K., Sivaswamy, A., Forbes, T.L., Sattar, N., Aljabri, B., Kayssi, A., Verma, S. and de Mestral, C. (2019) Population-Based Secular Trends in Lower-Extremity Amputation for Diabetes and Peripheral Artery Disease. Canadian Medical Association Journal, 191, E955-E961.
https://doi.org/10.1503/cmaj.190134

has been cited by the following article:

• 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.