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Changes in Residual Limb Anthropometrics and Lift, Carry, and Timed Walking Performance in Men with Transtibial Amputation due to Trauma

Introduction Despite advances in prosthetic management and rehabilitation, otherwise healthy men with transtibial amputation (TTA) risk residuum injury during work-related activity (WRA) performance. Little is known about WRAs, perceived exertion, or residuum anthropometric changes over time in this cohort. This information may help direct longer-term considerations for those with TTA within the workforce. Materials and Methods In this preliminary study, investigators prospectively examined and compared WRA performance (floor-to-knuckle lift, 25-ft carry, self-paced, and brisk 2-minute walk tests [2MWT]), gait asymmetry (differences in step length, stride length, and cadence), report of perceived exertion (RPE), and residuum anthropometrics (length, girths) in otherwise healthy men with TTA at least 6 months after rehabilitation, during two visits, 12 months apart. Results Twenty-one participants showed little difference between visits in residuum anthropometrics or in distances walked (self-paced, brisk 2MWT; p > 0.05). All had received rehabilitation varying from time of surgery and beyond initial receipt of prosthesis (n = 8; 38%) to only upon receipt of the initial prosthesis (n = 13; 62%). However, participants reported greater exertion at visit 2 during the brisk 2MWT (0.9 RPE difference; p = 0.034) but lifted 40.4 lb more at visit 2 than at the initial visit (p = 0.034). There was a progressively larger cadence difference from visit 1 to visit 2 (increased asymmetry) during the timed self-paced walk test (p = 0.026). Conclusions Regardless of improved lift capacity or residuum anthropometric stability, this healthy male cohort with TTA demonstrated progressively worsened cadence asymmetry during self-paced 2MWT and reported increased exertion during brisk-paced 2MWT. Otherwise healthy working-age men with TTA may require continual intervention to minimize cadence asymmetry and perceived exertion, potentially reducing residuum injury risk.