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Measuring the Daily Stepping Activity of People with Transtibial Amputation Using the ActivPAL™ Activity Monitor

Buis, Arjan W.P. PhD; Dumbleton, Tim PhD; Murray, Kevin D. PhD; McHugh, Brendan F. PhD; McKay, Geoff PhD; Sexton, Sandra BSc

JPO: Journal of Prosthetics and Orthotics: January 2014 - Volume 26 - Issue 1 - p 43–47
doi: 10.1097/JPO.0000000000000016
Original Article

ABSTRACT This study compared the general activity during 1 week and detailed activity during a 24-hr period of 48 established unilateral transtibial prostheses users. Activity was measured by instrumenting their prescribed prosthesis, which they have been using for a minimum of 6 months, with the ActivPAL™ activity monitor. Half (n = 24) were fitted with a prosthesis with total surface bearing (TSB) pressure-cast sockets (“hands-off” group), and the other half (n = 24) had been wearing prostheses with hand-cast patellar tendon-bearing (PTB) sockets (“hands-on” group). As a prerequisite, the long-term reliability of the ActivPAL activity monitor was assessed, and it was found to exhibit a high level of consistency between devices (intraclass correlation coefficient [ICC] of 0.997 during the 24-hr period). The monitors were used to examine the activity levels of the two groups of transtibial prostheses users wearing their own prosthesis. The results indicated that both subject groups were active throughout the day, walking a mean of more than 8000 steps. No statistically significant difference in daily stepping activity was seen between the two groups (p = 0.173). Despite differences in prosthetic socket design, the daily activity profiles of both subject groups were similar.

ARJAN W.P. BUIS, PhD; KEVIN D. MURRAY, PhD; TIM DUMBLETON, PhD; and BRENDAN F. MCHUGH, PhD, are affiliated with the Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK. GEOFF MCKAY, PhD, is affiliated with the Department of Mathematics, University of Strathclyde, Glasgow, UK. SANDRA SEXTON, BSc, is affiliated with Rehabskills Ltd, North Lanarkshire, UK.

Disclosure: The authors declare no conflict of interest.

This study was funded by Action Medical Research, grant reference AP0985.

No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.

Correspondence to: Arjan W.P. Buis, PhD, Department of Biomedical Engineering, University of Strathclyde, Curran Bldg, 131 St James Rd, Glasgow, G4 0LS, Scotland, UK; email:;

© 2014 by the American Academy of Orthotists and Prosthetists.