Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 8, 2014
   Pages 1287 — 1296

Abstract — Does unilateral transtibial amputation lead to greater metabolic demand during walking?

Elizabeth Russell Esposito, PhD;1–2* Kelly M. Rodriguez, MS;1 Christopher A. Ràbago, PT, PhD;1–2 Jason M. Wilken, PT, PhD1–2

1Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX; 2Department of Defense-Department of Veterans Affairs Extremity Trauma and Amputation Center of Excellence

Abstract — Previous literature reports greater metabolic demand of walking following transtibial amputation. However, most research focuses on relatively older, less active, and often dysvascular amputees. Servicemembers with traumatic amputation are typically young, fit, and highly active before and often following surgical amputation of their lower limb. This study compared the metabolic demand of walking in young, active individuals with traumatic unilateral transtibial amputation (TTA) and nondisabled controls. Heart rate (HR), rate of oxygen consumption, and rating of perceived exertion (RPE) were calculated as subjects walked at a self-selected velocity and at five standardized velocities based on leg length. The TTA group completed a Prosthetics Evaluation Questionnaire. Oxygen consumption (p = 0.89), net oxygen consumption (p = 0.32), and RPE (p = 0.14) did not differ between groups. Compared with controls, HR was greater in the TTA group and increased to a greater extent with velocity (p < 0.001). Overall, the TTA group rated their walking abilities as high (mean: 93% out of 100%). This is the first study to report equivalent metabolic demand between persons with amputation and controls walking at the same velocity. These results may reflect the physical fitness of the young servicemembers with traumatic amputations and may serve to guide outcome expectations in the future.

Key words: amputee, energetics, gait, heart rate, military, oxygen consumption, prosthetic, servicemember, speed, traumatic.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.8

This article and any supplementary material should be cited as:
Russell Esposito E, Rodriguez KM, Ràbago CA, Wilken JM. Does unilateral transtibial amputation lead to greater metabolic demand during walking? J Rehabil Res Dev. 2014;51(8):1287–96.
http://dx.doi.org/10.1682/JRRD.2014.06.0141
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