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Volume 43 Number 2, March/April 2006
Pages 153 — 160

Abstract - Influence of terrain on metabolic and temporal gait characteristics of unilateral transtibial amputees

Jean Paysant, MD;1-2* Christian Beyaert;, MD, PhD;1-2 Ange-Michel Datié, MD;1-3 Noël Martinet, MD, PhD;1 Jean-Marie André, MD, PhD1-2

1Institut Régional de Réadaptation de Nancy, Nancy, France; 2Faculté de Médecine, Université de Nancy, Nancy, France; 3Centre Hospitalier Universitaire de Yopougon, Abidjan, Côte d'Ivoire
Abstract — The difficulties confronted by amputees during overground walking are rarely investigated. In this study, we evaluated, in real-world situations, the influence of ground surface on walking in young, active amputees by measuring temporal and spatial gait parameters (free walking speed [FWS], step length [SL], step rate), energy expenditure (EE) (e.g., oxygen uptake, oxygen cost [O2C]), and Rating of Perceived Exertion (RPE). Ten active transtibial amputees and ten nondisabled control subjects walked at self-selected speeds on three types of ground surface (asphalt, mown lawn, and high grass). No significant differences were observed between the two groups on asphalt and mown lawn. Differences between nondisabled subjects and amputees occurred for FWS (p = 0.03) and O2C (p = 0.04) on asphalt and mown lawn and for all variables in high grass. When amputees (even though very active) were exposed to a particularly difficult environment, their FWS decreased (p = 0.008) and their EE and RPE increased (p = 0.005) compared with nondisabled subjects. In high grass, both groups reduced their self-selected speeds (-15% for control subjects and -16% for amputees). Control subjects reduced their velocity by reducing both SL (-8.7%) and cadence (-7.1%), whereas amputees reduced their velocity by reducing SL (-17%) only.
Key words: energy expenditure, ground surface, lower-limb amputee, metabolic characteristics, oxygen cost, oxygen rate, spatial gait parameters, temporal gait parameters, walking, walking speed.

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