Article

The aim of this study was to examine whether impaired balance control is partly
responsible for the increased energy cost of walking in persons with a lower limb
amputation (LLA). Previous studies used external lateral stabilization to
evaluate the energy cost for balance control; this caused a decrease in energy
cost, with concomitant decreases in mean and variability of step width. Using a
similar set-up, we expected larger decreases for LLA than able-bodied controls.
Fifteen transtibial amputees (TT), 12 transfemoral amputees (TF), and 15
able-bodied controls (CO) walked with and without external lateral stabilization
provided via spring like cords attached to the waist. Effects of this
manipulation on energy cost, step parameters, and pelvic motion were evaluated
between groups. TT (-5%) and CO (-3%) showed on average a small reduction in
energy cost when walking with stabilization, whereas TF exhibited an increase in
energy cost (+6.5%) The difference in the effect of stabilization was only
significant between TT and TF. Step width, step width variability, and
medio-lateral pelvic displacement decreased significantly with stabilization in
all groups, especially in TT. Contrary to expectations, external lateral
stabilization did not result in a larger decrease in the energy cost of walking
for LLA compared to able-bodied controls, suggesting that balance control is not
a major factor in the increased cost of walking in LLA. Alternatively, the
increased energy cost with stabilization for TF suggests that restraining
(medio-lateral) pelvic motion impeded necessary movement adaptations in LLA, and
thus negated the postulated beneficial effects of stabilization on the energy
cost of walking.
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Langue : ANGLAIS