title: Energy expenditure and walking speed in lower limb amputees: a cross sectional study.
abstract: BACKGROUND
  Energy expenditure and walking speed are generally recommended for use as measures of status and outcome for walking. The objective of this study was to measure the physiological cost index (PCI) and comfort walking speed (CWS) at three levels of lower limb amputation: transfemoral, transtibial and Syme level, and the relationship of these physiological variables to prosthetic ambulation supported with walking aids and stump length.
  
  
  METHODS
  This study was a prospective cross-sectional study.Eighty-nine individuals with lower limb amputation for reasons other than peripheral vascular disease (PVD) were recruited among patients at the Department of Prosthetics and Orthotics in University Clinical Center of Kosovo. PCI was assessed by five minutes of continuous indoor walking at CWS.
  
  
  RESULTS
  Significant differences were found in PCI (F=29.87, P < 0.001) and CWS (F=19.33, P < 0.001) among the three amputation groups. Prosthetic ambulation supported with crutches showed an important impact on PCI (F=35.1, P < 0.001) and CWS (F=28.42, P < 0.001). Stump length was associated with significantly increased PCI (r=0.53, P = 0.02) and reduced CWS (r=0.58, P = 0.004) in transfemoral amputees.
  
  
  CONCLUSIONS
  1. A higher level of amputation is associated with less energy-efficient walking and with lower walking speed. 2. Prosthetic ambulation supported with crutches has significant impact on increasing of energy expenditure and decreasing walking speed. 3. Stump length is shown to have a major impact on PCI and CWS in transfemoral amputees.
authors.affiliation: Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo.
authors.forename: Teuta Osmani
authors.initials: TO
authors.lastname: Vllasolli
authors.affiliation: Department of Epidemiology and Biostatistics, Faculty of Medicine, Skopje, Macedonia.
authors.forename: Beti
authors.initials: B
authors.lastname: Zafirova
authors.affiliation: Department of Epidemiology and Biostatistics, Faculty of Medicine, Skopje, Macedonia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Orovcanec
authors.affiliation: Orthopedic Clinic, Faculty of Medicine, Skopje, Macedonia.
authors.forename: Anastasika
authors.initials: A
authors.lastname: Poposka
authors.affiliation: Physical Medicine and Rehabilitation Clinic, University Clinical Center of Kosovo.
authors.forename: Ardiana
authors.initials: A
authors.lastname: Murtezani
authors.affiliation: Royal University "Iliria" - Faculty of Medicine Sciencies "Rezonanca", Prishtina, Kosovo.
authors.forename: Blerim
authors.initials: B
authors.lastname: Krasniqi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D001186:Artificial Limbs; D003430:Cross-Sectional Studies; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D063826:Kosovo; D035002:Lower Extremity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000072797:Walking Speed / Q000502:physiology*; D055815:Young Adult