Discussion
cardiovascular overload, stroke, amputations, pain, Muscular hypotrophy, muscle deficiency, muscle wasting, diabetes
HEART DISEASE, STROKE, UTA, CHRONIC DISEASES, MUSCLE WASTING, DIABETES
This study demonstrated the feasibility and effectiveness of a resistance and aerobic exercise training program for individuals with amputations. The authors compared the efficiency of supervised exercise with the results of Paralympic athletes. It is important to remember that higher aerobic capacity and greater skeletal muscle strength are associated with a lower prevalence of chronic diseases and lower mortality.The remarkable increases in max aerobic capacity (22%), oxygen pulse (20%), peak workload in the end exercise testing as well as muscle strength (peak torque corrected by body weight) and endurance (total work amputation) for the lower body (106% and 97%, respectively), demonstrated in this study the aerobic potential of the training program to reduce risks from chronic diseases such as heart disease, stroke, and diabetes, respectively. NolanAnother physiological element derived from the improvement of aerobic metabolism was the increase in the Oxygen Pulse (POIt is important to point out that there is research that supports the fact that the higher the amputation level, the energy demand increases, and, therefore, they require considerably higher levels of effort to perform the same rates of work compared to non-individuals amputees.Therefore, the main outcome of the study was that the level of strength and cardiorespiratory fitness of the dependent variables increased significantly in G1 patients with Unilateral Transtibial Amputation (UTA) after supervised concurrent training.The specific parameters of muscle strength in the pre-training phase of G1 were below what is necessary for the proper use of the prosthesis, since the normal physiological limit and the metabolic cost of gait in TA patients is ten to 30% higher than in non-patients amputees, with 22% less speed and with a high risk of developing cardiovascular overload and chronic diseases, evidencing the need for specific training for the use of the prosthesis and gait.The AT muscle condition was assessed through the thigh circumference and isokinetic dynamometry of the knee flexors and extensors. Both groups had muscle deficiency at baseline. Muscular hypotrophy was present: more than 3 cm of difference between the amputated and non-amputated thighs and the maximum extensor torque (velocity of 60°/s) was enough to support only half of the patient's body mass, which means that they were not able to support your body weight on the amputated leg (single leg support). Pedrinelli et al.Muscular hypotrophy is related to disuse (surgery and physical inactivity); local pain (stump condition); proprioceptive losses and senescence (20% muscle wasting between 25‒60 years of age).Muscle strength is considered one of the most important physical fitness qualities for human independence and is critical for amputees.Therefore, it is evident from these findings that well-programmed strength training is important in the rehabilitation of fragile groups right after the fitting, as verified in the literature.It is not new that the literature confirms the favorable effect of aerobic exercise on blood pressure.Aerobic interval exercises are known to improve VOKent et al.Better Mechanical Efficiency (ME) is linked to a greater economy of movement. Thus, it helps to reduce the oxygen demand to perform movements for longer and for greater distances at a given speed and can generate increases in resistance performance, an important condition for the amputee.When the authors analyzed this variable (the closer to 25%, the better) together with the others from the cardiopulmonary evaluation, we found that the Paralympic athletes (G2) were not statistically superior to G1. It is clearly noted that the EM is low in both groups of amputees, which characterizes high energy expenditure in these patients.The results of the present study show that a regular physical conditioning program for the TA after fitting is necessary to achieve adequate functional performance. The same recommendation is valid for parathletes, in the improvement of athletic performance. CT does not require expensive equipment and good results are directly related to the prior assessment of metrics, an efficient rehabilitation program, and progress monitoring, always seeking maximum performance.