Changes in physiological performance of the lower limb after fracture and subsequent rehabilitation

1. Eight patients who had suffered a fracture of one leg were studied before and after a 7 weeks period of rehabilitation during work with one leg and both legs on a bicycle ergometer. 2. In submaximal exercise minute ventilation for a given carbon dioxide output and tidal volume at a given minute ventilation remained unchanged throughout the period of therapy for both one- and two-leg exercise: oxygen intake for a given work output and cardiac frequency for a given oxygen intake decreased in both the injured and uninjured limb during one-leg work, although in two-leg exercise there was no significant change. 3. Oxygen intake at zero load was subtracted from the maximum oxygen intake measured during loaded exercise to give net values for each limb exercised separately or both legs exercised together. The net maximum oxygen intake thus calculated increased 8-9% (*17 1/min) in the uninjured leg and 17-4% (*29 1/min) in the injured leg during one-leg exercise. In two-leg exercise the increase was 17-2% (*43 1/min), which approximately equals the increase in the two legs measured separately. 4. In both legs there was an increase in leg muscle (plus bone) volume although this was significant in the injured leg only. 5. The maximum oxygen intake attained in two-leg exercise for a given leg volume in the patients at discharge was not significantly different from that found previously in a cross-sectional survey of young healthy (naval) servicemen. Thus the rehabilitation programme investigated appears to be effective, although the spontaneous recovery without a rehabilitation programme is unknown.