Energy expenditure of walking with prostheses: comparison of three amputation levels

Amputee patients spend more energy during walking than able-bodied persons. It is generally accepted that more proximal amputation is associated with more energy need. However, the picture is not clear, especially for partial foot amputees. The purpose of this study was to compare the energy consumption of walking in traumatic unilateral amputees with three different amputation levels (trans-femoral, trans-tibial and partial foot amputations). Sixty-four male unilateral traumatic amputees participated in this study. Energy expenditure during walking was measured for four different speed and slope combinations: 1.5 km/h and 0 degrees slope, 3 km/h and 0 degrees slope, 1.5 km/h and 5 degrees slope, 3 km/h and 5 degrees slope. Mean O(2) consumption (ml/kg/min) of the last 2 min of each 5-min session was calculated. In all four combinations, energy expenditure of trans-tibial amputees was the lowest, and energy expenditure of trans-femoral amputees was the highest. Statistical significance, however, could not be obtained for the differences among the groups. In conclusion, walking of partial foot amputees does not seem to be more energy efficient than that of higher level amputees.