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BMI Amputees - A Pilot Study
Background
Obesity time-bomb id “as big a threat to the planet as climate change”
How big is the problem?
- In 2008, almost a quarter of adults in England were classified as obese
- A greater proportion of men than women in England were classified as overweight in 2008
- 39% of adults had a raised waist circumfrerence in 2008 compared to 23% in 1993. Women wee more likely hen men to have a raised waist
- In 2008, 16.8% of boys aged 2-15, and 15.2% of girls were classed as obese, an increase from 11.1% and 12.2% respectively in 1995
For boys, on week days, the proportion who spent 4 or more hours doing sedentary activities was 35% of those , who were not overweight or obese, 44% of those classed as overweight and 47% of those classed as obese in 2008. For girls, a comparable pattern was found; 37%, 43% and 51% respectively.
Impact of weight on Prosthectic Use
The risks involved of being overweight or obese can effect many areas of the body internaly, mentaly and also may cause prothetice limitations. An over bearing body limits the user for choices of artificial limbs and can cause a great strain on the sockets and other supporting parts of the body.
166 subjects were involved (98 male), age 16-96 years (mean = 58.7)
Weight 47-140 kg, (mean = 88)
68 Transtibal 48 transfemoral amputees.
Trauma (49) PVD (29) Others (38).
1-66 years Post Amp, mean = 13.66 years.
Period of use of current prostheses was 0.5-28years, mean = 3.5
101 repairs were done in a period of 6 months.
The number of repairs was found to correlate significantly with weight (P value <0.001) and inversley with age (P value = 0.003).
No significant correlation was found between repairs and gender, cause of amputation, or level of amputation.
Body weight and age of amputee are determining factors in the frequency of repairs of lower limb prostheses,
Body Mass index (BMI)
- Most widely used diagnostic tool used to identify weight problems within a population
- Estimate ideal body weight based on height
- BMI can be estimated easily and accuratly
- Assumption of average body composition
- Consideration of limb loss
BMI for amputees
- BMI score places people into five categories dependanct on their lean body mass
| Perceived BMI | Face Value BMI | Adjusted BMI | |
|---|---|---|---|
| Underweight | 0 | 1 | |
| Normal | 6 | 10 | 5 |
| Overweight | 18 | 11 | 13 |
| Obese | 1 | 3 | 7 |
- In persons with lower-limb amputation BMI indicators are inaccurate when based on observed body weight
- Amputation affects the relationship between weight and height independant of the degree of obesity
- For a person with limb loss due to amputation body weight is often underestimation
- Two alternatives for estimating body weight in a person with an amputation
- Weight the amputated portion + add the extra weight
- Estimate the weight of the amputated portion
Aim
- Determine the awareness of people with a limb loss of BMI and their idea of healthy weight
- Adjust BMI to estimate the proportion of weight loss as a result of amputation to provide a more accurate representation of a person’s weight status.
Through researching the impact of BMI through amputeess and recording their weights properly it has been determind that the figures go as follows:
- BMI increased by 1.9 on average (7.4%) min 1.38 Max 2.54
- 11 out of 25 subjects increased their BMI category
