Energy cost of walking in transfemoral amputees: Comparison between Marlo Anatomical Socket and Ischial Containment Socket

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To compare energy cost of walking (ECW) and prosthesis-related perceived mobility with the Marlo Anatomical Socket (MAS(®)) and the Ischial Containment (IC) Socket. Transfemoral (TF) amputees were enrolled in the study. ECW tests were conducted inside, in a hallway with a regular floor surface. Subjects had to walk back and forth on a 61m linear course at their own self-selected speed. Metabolic and heart rate data were collected during the walking test using a portable gas analyzer. All measurements were made at steady state (SS). The tests were performed first using the IC socket and then after 30 days of MAS(®) use; the last test was carried out after 60 days of MAS(®) use. The amputees were also administered the Prosthetic Evaluation Questionnaire Mobility Section (PEQ MS) at the first and the last test to assess perceived potential for mobility using the prosthesis. Seven long-term prosthesis users were analyzed. Their mean age was 33.9±9.3 years; all were employed, active, and used IC sockets. At the third walking test, the ECW with the MAS(®) was significantly lower than that with the IC socket (p=.016). PEQ MS data also improved significantly at the last evaluation (p<.018). Results suggest that using the MAS(®), lowering the ECW and improving PEQ MS, could be a valid prosthesis design for active TF amputees compared to their usual IC socket.