Energy expenditure of trans-tibial amputees during ambulation at self-selected pace

Abstract

The purpose of this investigation was two-fold: 1) to compare the metabolic cost (VO2), heart rate (HR), and self-selected speed of ambulation of trans-tibial amputees (TTAs) with those of non-amputee subjects; and 2) to determine whether a correlation exists between either stump length or prosthesis mass and the energy cost of ambulation at the self-selected ambulation pace of TTAs. Subjects were thirty-nine healthy male non-vascular TTAs between the ages of 22 and 75 years (mean ± sd = 47 ± 16). All had regularly used their prosthesis for longer than six months and were independent of assistive ambulation devices. Twenty-one healthy non-amputee males aged 27–47 years (31 ± 6) served as controls. Subjects ambulated at a self-selected pace over an indoor course, with steady-state VO2, HR, and ambulation speed averaged across minutes seven, eight and nine of walking. Results showed that HR and VO2 for TTAs were 16% greater, and the ambulation pace 11% slower than the non-amputee controls. Significant correlations were not observed between stump length or prosthesis mass and the energy cost of ambulation. However, when the TTA subject pool was stratified on the basis of long and short stump length, the former sustained significantly lower steady-state VO2 and HR than the latter while walking at comparable pace. These data indicate that stump length may influence the metabolic cost of ambulation in TTAs.

Energy Costs & Performance of Transtibial Amputees & Non-amputees during Walking & Running

“…Our study is in agreement with the earlier study by Gailey et al [ 5 ] who reported that the energy costs of walking for TTA are signifi cantly increased and SSWS are slower compared to nonamputee controls. However, a major limitation of their study was the great variability in prosthetic components used by TTA subjects.…”

Factors related to high-level mobility in male servicemembers with traumatic lower-limb loss

“…Rehabilitation factors include muscle strength and power [6][7], range of motion, balance strategies and proprioceptive control [8][9][10][11], and gait pattern [10,[12][13][14]. Other factors include weight [15] and adiposity as reflected by waist circumference, age, time since amputation, number and level of amputations as reflected in the number of remaining intact knee and ankle joints [7,[16][17][18], and condition of the amputated and contralateral lower limb (if applicable), as well as length of the residual limb [19][20][21][22]. In addition, prosthetic feet [23][24][25][26][27] and knee units have been shown to affect basic prosthetic mobility and may also affect high-level mobility [12].…”

Ilizarov External Fixator for Stump Salvage in Infected Nonunions

“…Studies have shown that the metabolic costs of walking following amputation can be up to 200% greater than normal walking. [18][19][20] In terms of belowknee vs above-knee amputation, Marshall and Stansby 21 reported that walking with a prosthesis compared with normal ambulation required 25% to 40% more energy expenditure for a below-knee prosthesis vs 65% to 100% for an above-knee prosthesis. Hence, careful and early assessment of indications for a below-knee vs an above-knee amputation is important when considering amputation as a therapeutic option.…”