{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T06:37:42Z","timestamp":1764571062211,"version":"3.40.5"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Following traumatic lower\u2010limb amputation (LLA), humans are predisposed to numerous unfavorable changes in health, including the development of secondary chronic health conditions such as metabolic disorders and cardiovascular disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine within and between group differences in cardiometabolic component risks, body composition, and physical activity (PA) in individuals with traumatic unilateral and bilateral LLA, compared to noninjured controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A military complex trauma rehabilitation center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Sixteen males with traumatic LLA (8 unilateral, mean age 30\u2009\u00b1\u20095\u00a0years and 8 bilateral, mean age 29\u2009\u00b1\u20093\u00a0years). Thirteen active age\u2010matched males with no LLA (28\u2009\u00b1\u20095\u00a0years) acted as controls and performed habitual activities of daily living.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Participants with LLA attended two 4\u2010week periods of inpatient rehabilitation, separated by two 6\u2010week periods of home\u2010based recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Venous blood samples were taken prior to and following a 75\u2009g oral glucose load, for determination of biomarkers, including insulin and glucose, at baseline and 20\u2009weeks. Body composition (dual X\u2010ray absorptiometry) was measured at baseline, 10\u2009weeks, and 20\u2009weeks. Daily PA was recorded using a triaxial accelerometer for 7\u2009days during inpatient rehabilitation and while at home. Energy expenditure was estimated using population\u2010specific equations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Individuals with bilateral LLA demonstrated more unfavorable mean body composition values, lower PA, and increased cardiometabolic health risk compared to controls. Cardiometabolic syndrome was identified in 63% of individuals\u00a0with\u00a0bilateral LLA. No statistically significant differences in cardiometabolic component risk factors, body composition, and estimated daily PA were reported between unilateral LLA and control groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). While at home, mean PA counts.day<jats:sup>\u22121<\/jats:sup> reduced by 17% (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.018) and 42% (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.001) in the unilateral and bilateral LLA groups, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite extensive inpatient rehabilitation, cardiometabolic component risks are elevated in individuals with bilateral LLA but are comparable between unilateral LLA and active noninjured control groups. Innovative strategies that improve\/support the long\u2010term PA and cardiometabolic health of severely injured individuals with bilateral LLA are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12944","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T08:36:00Z","timestamp":1674117360000},"page":"413-425","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Influence of traumatic lower\u2010limb amputation on physical activity, body composition, and cardiometabolic risks: A descriptive preliminary study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9891-9714","authenticated-orcid":false,"given":"Peter","family":"Ladlow","sequence":"first","affiliation":[{"name":"Department for Health University of Bath  Bath UK"},{"name":"Academic Department of Military Rehabilitation (ADMR) Defence Medical Rehabilitation Centre (DMRC)  Loughborough UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas E.","family":"Nightingale","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Rehabilitation Sciences University of Birmingham  Birmingham UK"},{"name":"International Collaboration on Repair Discoveries (ICORD) University of British Columbia  Vancouver Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Polly","family":"McGuigan","sequence":"additional","affiliation":[{"name":"Department for Health University of Bath  Bath UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander N.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Academic Department of Military Rehabilitation (ADMR) Defence Medical Rehabilitation Centre (DMRC)  Loughborough UK"},{"name":"National Heart and Lung Institute, Faculty of Medicine Imperial College London  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francoise","family":"Koumanov","sequence":"additional","affiliation":[{"name":"Department for Health University of Bath  Bath UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhodri","family":"Phillip","sequence":"additional","affiliation":[{"name":"Complex Trauma Rehabilitation Department Defence Medical Rehabilitation Centre (DMRC)  Loughborough UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6701-7603","authenticated-orcid":false,"given":"James L. 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