Journal CME, April 2023: Influence of traumatic lower-limb amputation on physical activity, body composition, and cardiometabolic risks: A descriptive preliminary study-Influence of traumatic lower-limb amputation on physical activity, body composition, and cardiometabolic risks: A descriptive preliminary study

Influence of traumatic lower-limb amputation on physical activity, body composition, and cardiometabolic risks: A descriptive preliminary study

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This study by Peter Ladlow and colleagues aimed to explore the impact of traumatic lower-limb amputation (LLA) on physical activity, body composition, and cardiometabolic risk in military personnel. The researchers conducted a 20-week prospective observational cohort study at a military trauma rehabilitation center, assessing 16 male participants with either unilateral or bilateral LLA and comparing them with 13 age-matched, non-injured controls.<br /><br />The findings indicated individuals with bilateral LLA exhibited worse body composition, lower physical activity, and increased cardiometabolic risks than controls, despite extensive rehabilitation efforts. Specifically, 63% of the bilateral LLA participants met the criteria for cardiometabolic syndrome, characterized by high waist circumference, visceral adipose tissue (VAT), total body fat, altered lipid profiles, systemic inflammation, and impaired insulin sensitivity. In contrast, individuals with unilateral LLA displayed cardiometabolic risk profiles similar to the healthy control group, likely due to their engagement in structured rehabilitation and physical activity.<br /><br />Physical activity levels, measured through a triaxial accelerometer, were significantly lower in those with bilateral LLA, especially when transitioning from rehabilitation to home environments. The bilateral LLA group showed a 42% reduction in physical activity counts per day and a 47% decrease in physical activity energy expenditure when at home compared to during rehabilitation. Similarly, the unilateral group also saw reductions but to a lesser degree.<br /><br />In conclusion, while rehabilitation can help maintain cardiometabolic health in unilateral LLA comparable to healthy individuals, those with bilateral LLA face significantly increased risks and reduced physical activity. The study highlights the need for innovative long-term strategies to support PA and cardiometabolic health in individuals with severe injuries, particularly bilateral LLAs. These strategies could include tailored home-based interventions focusing on exercise and nutrition to mitigate risks following discharge from structured rehabilitation.

Keywords

traumatic lower-limb amputation

physical activity

body composition

cardiometabolic risk

military personnel

bilateral LLA

unilateral LLA

rehabilitation

cardiometabolic syndrome

home-based interventions