Use of predictive energy expenditure equations in individuals with lower limb loss at seated rest

As a result of the global war on terrorism, there has been a significant increase in young service members with traumatic amputations. Few published data are available on metabolic requirements for young, active individuals after traumatic limb loss, especially lower limb loss.

The purpose of this study was to determine which predictive energy equation best predicted resting energy expenditure (REE) in this population.

One hundred service members, 50 with at least one traumatic lower limb loss and 50 without limb loss, completed this study. Mean (standard deviation [SD]) age, height, and weight were 27.3 years (±5.3), 178.5 cm (±7.7), 86.5 kg (±15.8) for those with limb loss; and 29.4 years (±5.8), 179.1 cm (±6.7), 85.9 kg (±12.6) for those without. REE was measured using the Oxycon Mobile metabolic system (CareFusion). Measured REE was compared with the following REE equations: Mifflin-St Joer, Harris Benedict, Owen, 25 kcal/kg, and 30 kcal/kg.

All equations tended to underestimate or overestimate REE for both groups (P<0.001); however, the 25 kcal/kg had a more even distribution of disagreement for individuals with limb loss and without (P=0.100 and P=0.308, respectively), with 52% within ±10%.

The 25 kcal/kg best predicts REE for young, active individuals with or without limb loss. Future studies may determine that more appropriate equations are most useful for different subgroups of this population.