Effect of Eight-week Concurrent Training on Functional Capacity in Patients With Unilateral Transtibial Amputation

Primary outcomes

1. Functional assessment- Sit to Stand

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   Dynamic functional capacity assessment: patient sit to stand from a standard chair (40 centimeters high, 45 centimeters wide and backrest 90 degrees). Have to do the task five times as fast as possible time; measured in time - seconds (sec).

2. Functional Mobility - Time-up and Go Test

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   Time-up and Go Test (TUGT) - patient sit in a standard chair (40 centimeters high, 45 centimeters wide and backrest 90 degrees), trunk resting on backrest, after a verbal command has to stand up, walk for three meters (m) turn, return and sit in the chair as fast as possible; measured in time - seconds (sec).

3. Abiliity Test- Climb Steps

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   Time to climb 15 steps (height 15 centimeters / depth 30 centimeters), as quickly as possible; measured in time - seconds (sec).

4. Muscular strength- Isokinetic Dynamometry

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   Evaluation of muscular strength improvement - Isokinetic dynamometry will be use to determine knee extension and flexion strength using the Biodex Multi-Joint System 3 (Biodex MedicalTM, Shirley, NY, USA). The isokinetic variables used were maximum peak torque corrected for body weight (%), and total work (J).

5. Exhaled gas analyze - Ergospirometry

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   An exercise bike exercise test (Biocycle 2600 Electromagnetic Moviment, Brazil) was performed using the modified Astrand protocol which recommends a speed of 60 revolutions per minute (rpm) with progressive load increase (w). Two minutes (min) and the load was increased by 25 by 25 watts (w) in a stepwise fashion until maximum effort was achieved. Exhaled gas analysis was performed using the computerized metabolic gas analyzer (CPX / Ultima, MedGraphics®, St. Paul, Minnesota, USA). The maximum oxygen uptake (VO2max in ml / kg / min) was mainly evaluated.

6. Dynamic and static balance-Balance platform

   Time frame: This measure will be performing before and after the innervation (8 weeks of concurrent training 3 times a week.).

   Static and dynamic balance was evaluated by the Balance Master System version 8.1 (NeuroCom International, Inc. Clackamas, OR). The system consists of a dual force platform coupled to a microcomputer. Platform force sensors measure ground reaction force (° / s) while performing tasks such as sitting and rising from a chair by measuring the force distribution between the lower limbs in percent (%). The variables will be the mean weight transfer index (%), mean movement time (s) and mean impact index.