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Metabolic Cost and Stability of Locomotion in People with Lower Limb Amputation

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Abstract
It is generally accepted that metabolic energy expenditure and gait stability are key factors that influence the selection of able-bodied locomotor patterns. It is unclear how energy expenditure and gait stability are prioritized during walking in people with lower limb amputation. People with lower limb amputation generally have greater metabolic energy expenditure during walking and increased incidence of falls. People with unilateral lower limb amputation spend more time on the intact limb compared with the prosthetic limb, while able-bodied individuals generally walk with symmetrical timing between limbs. Restoring symmetry is often a goal of rehabilitation and assistive devices, yet the gait differences for people with unilateral amputation relative to able-bodied walkers could in fact be optimal for metabolic energy expenditure and stability. The purpose of this dissertation was to determine how metabolic energy expenditure and gait stability are affected by inter-limb gait asymmetry in people with and without unilateral transtibial amputation. To the best of my knowledge, this is the first set of studies to have people with amputation walk with preferred (i.e., asymmetrical) and non-preferred (i.e., symmetrical and greater asymmetry) inter-limb stance timing in order to understand how metabolic energy expenditure and gait stability are affected by asymmetry. Results from the first study found that subjects with amputation walked with more time on intact side compared with the prosthetic side, while able-bodied subjects walked with near symmetry (
Type
dissertation
Date
2019-05
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