Nutritional Anthropometry for Amputees: Challenges for Clinicians



Anthropometric measurements pose interesting challenges for clinicians when attempting to perform and interpet these in individuals with a lower extremity amputation. With little evidence to guide best practice, when clinicians do incorporate anthropometry into their practice they tend to apply measures with demonstrated validity in other populations. Following a comprehensive literature review, very few studies challenging the application of anthropometric measurements in those with a lower extremity amputation were identified. Largely the literature makes recommendations to continue to utilise body mass index, with complex equations developed to enable estimation of weight for the amputated limb. Alternatively the literature advocates for adopting measurements of the upper body while acknowledging that while these have correlation with measures such as body mass index, there is yet no information on whether these measures have any predictive ability in terms of health outcomes. The ideal approach is thus still controversial and research should focus on evaluating the ease and validity of various anthropometic measurements amongst those with a lower extremity amputation with a view to establish best practice recommendations for this group.


Amputate Limb Lower Extremity Amputation Nutritional Health Transfemoral Amputation Knee Height 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Body mass index


Corrected Arm Muscle Area


Health Related Quality of Life


Mid Arm Muscle Circumference


Mid Upper Arm Circumference


National Health Service Quality Improvement Scotland


National Institute for Health and Clinical Excellence


United Kingdom


World Health Organisation


  1. Amputees United of Australia. 2008. Available at: Accessed 23 Jan 2010.
  2. Asano M, Rushton P, Miller WC, Death BA. Prosth Orthotics Int. 2008;32(2):231–43.CrossRefGoogle Scholar
  3. Artificial Limb Services within Australia. Monash University. 2010. Available at: Accessed 23 Jan 2010.
  4. Australian Institute of Health & Welfare. 2009. Available at: Accessed 17 Feb 2010.
  5. Bassey EJ. Ann Hum Biol. 1995;13:499–502.CrossRefGoogle Scholar
  6. Boonstra AM, Schrama J, Fidler V, Eisma WH. Scand J Rehabil Med. 1995;27:77–81.PubMedGoogle Scholar
  7. Cheifetz O, Bayley M, Grad S, Lambert D, Watson C, Minor K. Prosthet Orthot Int. 2007;31:300–12.PubMedCrossRefGoogle Scholar
  8. Council of Europe Resolution Res Ap. Food and nutritional care in hospitals: How to prevent undernutrition. Report and Recommendations of the Committee of Experts on Nutrition, Food Safety and Consumer Protection. Council of Europe Publishing; 2003.Google Scholar
  9. Eneroth M, Apelqvist J, Larsson J, Persson BM. Int Orthop. 1997;21:104–8.PubMedCrossRefGoogle Scholar
  10. Haboubi NH, Heelis M, Woodruff R, Al-Khawaja I. J Rehabil Res Dev. 2001;38:375–7.PubMedGoogle Scholar
  11. Happich M, John J, Stamenitis S, Clouth J, Polnau D. Diab Res Clin Pract. 2008;81:223–30.CrossRefGoogle Scholar
  12. Innocencio da Silva A, Ribeiro BG, de Abreu Soares E. Nutritional profile of the Brazilian Amputee Soccer Team during the precompetition period for the world championship. Nutrition. 2006;22:989–95.CrossRefGoogle Scholar
  13. Kurdibaylo SF. J Rehabil Res Dev. 1996;33:387–94.PubMedGoogle Scholar
  14. Lehmann AB, Bassey JE, Morgan K, Dallosso HM. Clin Nutr. 1991;10:18–22.PubMedCrossRefGoogle Scholar
  15. Miller M, Wong WK, Wu J, Cavenett S, Daniels L, Crotty M. Archiv Phys Med Rehabil. 2008;89:2031–3.CrossRefGoogle Scholar
  16. Mozumdar A, Roy SK. Am J Clin Nutr. 2004;80:868–75.PubMedGoogle Scholar
  17. Mozumdar A, Roy SK. Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation. Eur J Clin Nutr. 2006;60:1180–88.PubMedCrossRefGoogle Scholar
  18. National Limb Loss Information Center. Amputation Statistics by Cause Limb Loss in the United States. 2008. Available at: Accessed 23 Jan 2010.
  19. NHS NSS. National Amputee Statistical Database for the UK. 2009. Available at: = nasdab/news/Final_2006_07.pdf. Accessed 12 Nov 2009.
  20. NHS Quality Improvement Scotland. Clinical Standards for Food, Fluid and Nutritional Care in Hospitals, 2003.Google Scholar
  21. NHS Quality Improvement Scotland. Clinical Standards: Food, Fluid and Nutritional Care in Hospitals. 2003. Available at:,%20Fluid%20Nutrition.pdf. Accessed 23 Jan 2010.
  22. NICE Clinical Guideline 32. Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition. 2006. Available at: Accessed 23 Jan 2010.
  23. NICE Clinical Guideline 43. Obesity: Guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children. 2006. Available at: Accessed 23 Jan 2010.
  24. Osterkamp LK. J Am Diet Assoc. 1995;95:215–8.PubMedCrossRefGoogle Scholar
  25. Tzamaloukas AH, Murata GH. Adv Perit Dial. 1996;12:143–6.PubMedGoogle Scholar
  26. Tzamaloukas AH, Patron A, Malhotra D. J Parenter Enteral Nutr. 1994;18:355–8.CrossRefGoogle Scholar
  27. Watterson C, Fraser A, Banks M, Isenring E, Miller M, Silvester C, Hoevenaars R, Bauer J, Vivanti A, Ferguson M. Nutr Dietet. 2009;66:S1–34.CrossRefGoogle Scholar
  28. WHO. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. WHO Technical Report Series 854. Geneva: World Health Organization; 1995.Google Scholar
  29. Wilson PWF, Kannel WB. Am J Geriatr Card. 2002;11:119–23.CrossRefGoogle Scholar
  30. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Arch. Phys Med Rehabil. 2008;89:422–9.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Dietetics, Nutrition & Biological Sciences, School of Health SciencesQueen Margaret UniversityEdinburghUK
  2. 2.Nutrition and DieteticsFlinders UniversityEdinburghUK

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