title: Improvement in walking abilities in transfemoral amputees with a distal weight bearing implant.
abstract: BACKGROUND
  The ability to walk with a prosthesis is the main objective of rehabilitation following amputation, and distance and speed of walking achieved are considered determining factors in amputees' perception of quality-of-life.
  
  
  OBJECTIVE
  To assess walking abilities and improvement in gait distance and speed parameters in patients undergoing transfemoral amputation with a femoral implant that allows distal support of the residuum.
  
  
  METHODS
  Experimental before-and-after study.
  
  
  METHODS
  Ten transfemoral amputation patients received a titanium implant that allowed distal weight bearing of the residuum within the socket. The post-intervention follow-up period was 14 months. We evaluated the functionality using a 2-min walk test and the physiological cost index.
  
  
  RESULTS
  The etiology of amputation was traumatic in six patients (60%). The mean 2-min walk test score was 98.4 ± 19.5 m prior to the femoral implant and 122.5 ± 26.1 m at 14 months ( p < 0.008), representing an improvement of 24.5%. The mean gait speed prior to the femoral implant was 0.82 ± 0.16 and 1.02 ± 0.21 m/s at 14 months ( p < 0.008). The physiological cost index showed no differences ( p < 0.55).
  
  
  CONCLUSIONS
  The results of this study show an improvement in the distance walked and gait speed in amputees 14 months after having received a femoral implant. Clinical relevance This article provides additional insight into the use of a femoral implant that allows distal support of the residuum to improve walking abilities and gait distance and speed parameters in patients undergoing transfemoral amputation, mainly those of vascular origin.
authors.affiliation: 1 Hospital de Mataro, Mataro, Barcelona, Spain.
authors.forename: Lluis
authors.initials: L
authors.lastname: Guirao
authors.affiliation: 1 Hospital de Mataro, Mataro, Barcelona, Spain.
authors.forename: C Beatriz
authors.initials: CB
authors.lastname: Samitier
authors.affiliation: 1 Hospital de Mataro, Mataro, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Costea
authors.affiliation: 2 Ortopedia GIO, Girona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Camos
authors.affiliation: 1 Hospital de Mataro, Mataro, Barcelona, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Majo
authors.affiliation: 1 Hospital de Mataro, Mataro, Barcelona, Spain.
authors.forename: Eulogio
authors.initials: E
authors.lastname: Pleguezuelos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000674:Amputees; D001186:Artificial Limbs; D065187:Controlled Before-After Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011788:Quality of Life; D016138:Walking / Q000502:physiology*; D016474:Weight-Bearing / Q000502:physiology*
keywords: Gait; osseointegration; prosthetics