Original articleInterlimb Muscle and Fat Comparisons in Persons With Lower-Limb Amputation
Section snippets
Study Design
This study is a cross-sectional, repeated-measures design comparing absolute and relative amounts of bone-free lean and fat tissue, and muscle and fat areas in the lower limbs of persons with unilateral TF and TT amputations. Furthermore, persons without amputations were tested as control participants, primarily to show interlimb variations in soft tissue not attributable to amputation. Thigh muscle volume and area data from previous amputee studies7, 8 resulted in large effect sizes, creating
Results
Table 1 shows participant characteristics. Subjects ranged in age from 23.2 to 62.9 years. There were no significant differences in whole-body composition characteristics between groups. Table 2 shows results of the soft-tissue analyses from pQCT (MCSA and fat cross-sectional area) and DXA (bone-free lean body mass and FM). MCSA values were significantly lower (F1,12=28.7–30.0, ηp2=.71; F1,8= 62.5–68.9, ηp2=.89–.90, P<.01) on the amputated limb for TF and TT groups, and the amputated limb
Discussion
To our knowledge, this is the first study that has quantified leg composition at the end of the residual limb. The MCSA was smaller, and relative FM was higher in the amputated limb compared with the intact limb. Qualitatively, pQCT analyses showed that the ends of residual limbs had noticeable amounts of intermuscular fatty tissue. Although the mean percent difference in the fat cross-sectional area between limbs for the TT group was much greater than for the TF group, the lack of significance
Conclusions
Muscle losses in the thigh muscles of TF and TT amputated limbs were evident. Also, there were large amounts of intermuscular adipose tissue at the end of residual limbs. Studies are needed to determine the uniformity of muscle and fat changes in the distal segments of residual limbs.
Acknowledgments
We thank Hanger Prosthetics and Orthotics, Inc and Kyle Sherk, CPO, for assistance with subject recruitment.
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