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Hsu Miao-Ju MA PT; Nielsen, David H. PhD, PT; Yack, John PhD, PT; Shurr, Donald G. MA, PT, CPO; Lin, Suh-Jen MS, PT
JPO Journal of Prosthetics and Orthotics: August 21st, 2000
Physiological Comparisons of Physically Active Persons with Transtibial Amputation Using Static and Dynamic Prostheses versus Persons with Nonpathological Gait during Multiple-Speed Walking: PDF Only
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ABSTRACT

The level of physical activity may be a potential correlate of accommodation to amputee walking. The purpose of this study was to compare the energy cost, gait efficiency, and relative exercise intensity of physically active persons with transtibial amputation during walking with the solid ankle cushioned heel (SACH) foot, the Flex-Foot (FF), and the Re-Flex Vertical Shock Pylon (VSP) prosthesis versus persons with nonpathological gait. Subjects were healthy, physically active males, including five subjects with unilateral transtibial amputation and 18 control subjects with nonpathological gait. A repeated-measures design involving multiple-speed treadmill walking (53.64, 67.05, 80.46, 93.87, and 107.28 m/min) was used. Between-group analyses involved separate repeated-measures analysis of variance according to foot type with a priori pairwise contrasts at each test speed. Betweengroup SACH and FF analyses showed nonsignificant differences in energy cost and gait efficiency for 53.64, 67.05, and 80.46 m/min, but significantly increased energy cost and decreased gait efficiency for 93.87 and 107.28 m/min. Between-group Re-Flex VSP analyses indicated nonsignificant differences for all test speeds. The relative exercise intensity of subjects with transtibial amputation for all foot types was significantly higher than that for controls across all walking speeds. Physically active individuals with transtibial amputation may have enhanced adaptability optimizing gait performance regardless of foot type at both slower and higher walking velocities with the Re-Flex VSP.

MIAO-JU HSU, MA, PT, is a PhD student in the Physical Therapy Graduate Program in the Division of Associated Medical Sciences/College of Medicine at the University of Iowa, Iowa City, IA.

DAVID H. NIELSEN, PhD, PT, is director and professor of the Physical Therapy Graduate Program in the Division of Associated Medical Sciences/College of Medicine at the University of Iowa.

H. JOHN YACK, PhD, PT, is associate professor of the Physical Therapy Graduate Program in the Division of Associated Medical Sciences/College of Medicine at the University of Iowa.

DONALD G. SHURR, MA, PT, CPO, is district manager for American Prosthetics, Inc, in Iowa City, IA, and adjunct lecturer for the Physical Therapy Graduate Program in the Division of Associated Medical Sciences/College of Medicine at the University of Iowa.

SUH-JEN LIN, MS, PT, is a PhD student in the Physical Therapy Graduate Program in the Division of Associated Medical Sciences/College of Medicine at the University of Iowa.

This study was supported in part by Flex-Foot, Inc., Aliso Viego, California, with Dr. David H. Nielsen as the principal investigator.

David H. Nielsen, PhD, PT, Physical Therapy Graduate Program, University of Iowa, 2600 Steindler Building, Iowa City, IA 52242-1008. Phone: (319) 335-9801; Fax: (319) 335-9707; E-mail: david-nielsen@ uiowa.edu

© 2000 American Academy of Orthotists & Prosthetists