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Titolo:
MUSCLE METABOLISM CHANGES WITH TRAINING IN THE NONAMPUTATED LIMB AFTER VASCULAR AMPUTATION - INTEREST OF PHOSPHORUS 31 NMR-SPECTROSCOPY
Autore:
DULIEU V; CASILLAS JM; MAILLEFERT JF; WALKER P; COTTIN Y; DIDIER JP; BRUNOTTE F;
Indirizzi:
CTR HOSP UNIV DIJON,CTR READAPTAT,23 RUE GAFFAREL F-21034 DIJON FRANCE CTR HOSP UNIV DIJON,CTR READAPTAT F-21034 DIJON FRANCE CTR HOSP UNIV DIJON,BIOPHYS LAB F-21034 DIJON FRANCE CTR HOSP UNIV DIJON,SERV RHUMATOL F-21034 DIJON FRANCE
Titolo Testata:
Archives of physical medicine and rehabilitation
fascicolo: 8, volume: 78, anno: 1997,
pagine: 867 - 871
SICI:
0003-9993(1997)78:8<867:MMCWTI>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAGNETIC-RESONANCE SPECTROSCOPY; PERIPHERAL ARTERIAL-DISEASE; INTERMITTENT CLAUDICATION; CALF MUSCLE; BLOOD-FLOW; LEGS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
26
Recensione:
Indirizzi per estratti:
Citazione:
V. Dulieu et al., "MUSCLE METABOLISM CHANGES WITH TRAINING IN THE NONAMPUTATED LIMB AFTER VASCULAR AMPUTATION - INTEREST OF PHOSPHORUS 31 NMR-SPECTROSCOPY", Archives of physical medicine and rehabilitation, 78(8), 1997, pp. 867-871

Abstract

Objective: To determine by P-31 nuclear magnetic resonance (NMR) spectroscopy the efficacy of training in improving aerobic metabolism of calf muscle in nonamputated limb after recent vascular amputation; to assess the possible associated microcirculatory changes; and to evaluate the need for noninvasive monitoring techniques during training in the nonamputated limb after recent vascular amputation. Design: Prospective study, before and after training. Subjects served as their own controls and were compared with a control group. Setting: Rehabilitation center of a university hospital. Patients: Ten unilateral vascular amputated patients were included with ankle systolic index between 0.5 and 0.8 in the nonamputated limb, and 10 control subjects without cardiovascular disease or risk factors of atherosclerosis with ankle systolic index of >.95. Intervention: Walking with prosthesis at self-selected velocity over increasing walking distance, arm training at a workload of 60% of a maximal arm test, and analytical exercises of the nonamputated leg (dynamic contractions against low resistance), Subjects received training as inpatients, 5 days a week. Main Outcome Measures: Before and after training, ankle systolic index, forefoot transcutaneousoxygen tension (TcPo2) and veno-arteriolar reflex, and digital plethysmography of the second toe with reactive hyperemia test were studied. Changes in calf muscle pH, phosphocreatine (PCr), and inorganic phosphate (Pi) were measured by P-31 NMR spectroscopy at rest and during a plantar flexion-type incremental protocol. Results: There was no significant difference in ankle systolic index (.63 +/- .10 vs .64 +/- .07)or in TcPo2 (42 +/- 11 vs 44 +/- 10mmHg), and there was reappearance of veno-arteriolar reflex in 3 cases, of a plethysmographic signal in 2 cases, and of the positivity of the reactive hyperemia test in 3 cases. No differences were found with P-31 NMR spectroscopy at rest before and after training. At the same workload (1 watt) the difference of the ratio (PCr/(PCr + Pi)) of rest to effort (PCr depletion) was significantly increased in the amputated patients (.423 +/- .159 vs .145 +/- .058; p <.01). This difference of ratio was lower after training (.360 +/- .158 vs .423 +/- .159; p <.05). The pH was less acid between the two periods. Conclusion: Vascular monitoring with systolic index andTcPo2 is necessary to follow and to prevent serious ischemia of the nonamputated limb. Claudication is often not detected because of early exhaustion during walking. Training after recent vascular amputation improves the skeletal muscle oxydative capacity. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 22:19:26