title: Is hip muscle strength the key to walking as a bilateral amputee, whatever the level of the amputations?
abstract: BACKGROUND
  Little data have been reported on the factors that are important in bilateral amputee walking ability especially the role of hip strength.
  
  
  METHODS
  Observational, case-control study where participants were evaluated at a single point in time.
  
  
  OBJECTIVE
  The aim of this study was to investigate the factors involved in bilateral amputee walking ability by assessment of walking speed, perceived exertion, exercise intensity, physiological cost index (PCI) and hip muscle strength.
  
  
  METHODS
  For a group of 10 bilateral amputees, with different levels of amputation, and a non-pathological reference group, walking ability was assessed using the two-minute walk test. Hip muscle strength was assessed using isokinetic strength tests.
  
  
  RESULTS
  Bilateral amputees were found to have slower walking speeds and increased PCI of walking which were correlated to higher levels of amputation. Peak hip torques were reduced in the amputees, which was only significant for concentric extension torque (p = 0.029), and approaching significance for concentric flexion (p = 0.061) and abduction (p = 0.057). Bilateral amputee peak hip strength suggested a positive trend with increasing walking ability.
  
  
  CONCLUSIONS
  Bilateral amputee walking ability was reduced and mainly related to level of amputation. The role of hip strength in bilateral amputee walking ability requires further investigation.
authors: Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands. j.m.a.visser@tudelft.nl
authors: Jma
authors: J
authors: Visser
authors: I
authors: I
authors: McCarthy
authors: L
authors: L
authors: Marks
authors: R C
authors: RC
authors: Davis
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation; D000674:Amputees; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D006621:Hip Joint / Q000502:physiology*; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology*; D010807:Physical Endurance; D005082:Physical Exertion; D016138:Walking / Q000502:physiology*