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February 20, 1967

Cardiac Evaluation in Consideration of Prostheses for Geriatric Amputees

Author Affiliations

From the Schwab Rehabilitation Hospital (Drs. Perlman, Kohn, Neumann, and Mr. Ho); the Department of Medicine (Dr. Perlman) and the Department of Physical Medicine and Rehabilitation (Dr. Kohn), College of Medicine, University of Illinois; the Department of Medicine (Dr. Perlman), and the Division of Physical Medicine and Rehabilitation (Dr. Kohn), Michael Reese Hospital and Medical Center; Cook County Hospital (Dr. Perlman); and the Chicago Medical School and Mount Sinai Hospital (Dr. Neuman), Chicago.

JAMA. 1967;199(8):532-536. doi:10.1001/jama.1967.03120080066010

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.