The Energetics of Transitibal and Transfemoral Amputees Walking on Titanium and Stainless Steel Prostheses

Abstract

Several studies have been devoted to the metabolic costs of amputees walking on prostheses with different masses added to their components. However, limited study has been directed at quantifying the mass differences of the actual materials available to amputees and the metabolic and mechanical work required to walk on these materials. The energetics of two materials currently used in the design of lower extremity prosthetics were examined in an attempt to determine if mass differences had an effect on amputee walking. A total of fifteen, unilateral amputees (8 transfemoral and 7 transtibial) performed treadmill walking on prostheses assembled from titanium and stainless steel components. Standardized components (knees, pylons, adapters, feet) made from each material were added below the level of the socket. Submaximal oxygen consumption {W/kg} and mechanical power allowing transfers within and between segments {W/kg} were calculated as subjects walked at self-selected velocities until steady state was achieved. Results show that despite significant mechanical differences [F(1,12)= 4.85, p<.048], the decreased mass associated with the use of titanium materials does not have an effect on the metabolic costs [F(1,14)=1.45, p<.249] of the subjects in this study. In addition, stride rate and stride length showed little differences when walking with both materials. Further division of subjects by age and experience walking on a prosthesis do suggest that older amputees and established walkers do benefit most from the use of titanium, both metabolically and mechanically. The choice of materials for use in every day walking will display differences in the mechanical work of amputees however, these differences are not great enough to realize metabolic consequences.