Dynamic electrocardiography was used to monitor the cardiovascular response of unilateral amputees of prosthetic training. Sixty-five patients were admitted to the study from a total of 79 patients; none of the 14 rejected was disqualified because of cardiac disease. Fifty-eight patients completed the study, only one failure was because of cardiac difficulty. During preprosthetic and prosthetic training, various electrocardiographic changes were observed; these included significant rhythmic variations, T wave flattening and inversion, and varying degrees of ST segment depression. Training was interrupted or delayed until clinical symptoms of cardiac difficulties disappeared or until the dynamic electrocardiographic pattern became stable. Hopping in parallel bars was found to be the most stressful aspect of prosthetic training. Pylon walking is an effective and less stressful substitute. Valuable information concerning cardiac response was obtained by dynamic electrocardiographic monitoring.
Perlman L, Kohn KH, Neumann M, Ho E. Cardiac Evaluation in Consideration of Prostheses for Geriatric Amputees. JAMA. 1967;199(8):532–536. doi:10.1001/jama.1967.03120080066010
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