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Background High-level lower extremity amputation (HLLEA) has significant impact on an individual's ability to ambulate and maintain cardiovascular fitness for extended periods of time. Objective The purpose of this study was to evaluate whether body weight support (BWS) would improve energy efficiency in an individual with HLLEA to achieve appropriate target cardiovascular intensity for aerobic training. Design This was an exploratory single-subject study. Methods The participant was a 45-year-old woman, 4.5 years after left hip disarticulation secondary to necrotizing fasciitis with resultant organ failure and cardiomyopathy. She was wearing a well-fitted prosthesis and had a goal of ambulating in the community with less fatigue. Vital signs and expiratory gases were recorded, and oxygen uptake efficiency slope was calculated during treadmill walking at 0%, 20%, and 40% unweighting. An age-matched control completed 0% unweighting baseline testing. Results Under all conditions of treadmill walking, the participant's heart rate, blood pressure, and rate of perceived exertion consistently increased as speed and time increased. The participant's oxygen uptake efficiency slope was most efficient at 20% unweighting, and the economy of movement improved as the percentage of BWS increased, bringing values closer to the age-matched control. The participant reported only minimal pain immediately following 20% unweighting. Limitations The primary limitation of this study is generalizability of findings because of minimal information for comparing the effects of BWS on aerobic capacity in individuals with HLLEA. Additionally, the percentages of unweighting using BWS were extrapolated based on corollary preexisting research; thus, there were no set parameters defined for this specific population. Conclusions BWS allowed the participant to work more efficiently, which suggests that if used during an intervention, BWS might enable individuals with HLLEA to achieve recommended levels of training for aerobic conditioning. In future studies, it is recommended that 20% BWS be used at a speed that results in moderate-intensity exercise for individuals with HLLEA as determined by 50% to 70% of maximum heart rate for 20 to 30 minutes.

The primary purpose of the study was to compare the response to bicycle ergometer exercise in children with and without juvenile rheumatoid arthritis (JRA). Heart rate, exercise duration, highest work load completed, and peak oxygen consumption (peak VO2) were compared. A secondary purpose of the study was to determine the relationship between peak VO2 and articular disease severity. Thirty children with JRA and 30 controls matched for age, sex, and body surface area (BSA) were the subjects. Peak VO2 was determined by an open-circuit computerized gas analysis system. Peak VO2, highest work load completed, exercise duration, and peak heart rate were significantly lower among the children with JRA than their respective controls. Submaximal heart rate was significantly higher for the children with JRA. There was no difference in resting heart rate between the two groups. There was no relationship between peak VO2 and articular disease severity among the children with JRA. The results suggest that aerobic conditioning programs may be indicated soon after diagnosis for patients with JRA, regardless of the severity of their articular disease. One subject with JRA and 2 control subjects reported light-headedness and dizziness, and 1 subject with JRA complained of increased knee swelling. We recommend that physical therapists monitor patients for signs of exercise intolerance and joint symptoms during exercise training sessions. [Jasso Giannini M, Protas EJ. Exercise response in children with and without juvenile rheumatoid arthritis: a case-comparison study.

The purpose of the study was to investigate possible psychological changes in obese men after participating in an eight-week nutrition and physical conditioning program. The subjects, 45 male, metropolitan policemen who were considered at least 20 percent over their optimum body weights, were placed on diets and received weekly instruction on topics of nutrition and exercise. The subjects were randomly divided into two groups, one that participated in aerobic conditioning and one that did not. The amount of oxygen consumption, as an index of physical fitness, and performance on selected subscales of the Tennessee Self-concept Scale (TSCS) were measured before and after the training and conditioning programs. Both groups displayed significant increases in oxygen consumption and on the Physical Self and Self-satisfaction subscales, but on all these measures, the Conditioning Group increased significantly (2 to 3 times) more. For both groups, the Total Variability measure from the TSCS showed significant reductions, which have been associated with personality integration. These results demonstrate that physical conditioning and dietary educational sessions or educational sessions alone are associated with positive changes in self-concept in obese individuals and also corroborate other studies that show links between physical and psychological fitness.