Energy Cost with Prosthetic Gait

Spring is here-let’s get up and moving! In celebration of National Limb Loss & Limb Difference Awareness Month, The O&P PT will be featuring a series of educational blog posts focusing on energy cost associated with prosthetic gait.

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Walking with a prosthesis can take up to 100-200% more energy than typical gait¹. This statistic may come of no surprise to those who ambulate with a prosthesis every day. Advancing the long lever arm of a prosthesis with the shorter lever arm of a residual limb requires great demand of the body’s musculoskeletal and cardiovascular systems. Available musculature must be recruited to stabilize the residual limb within the prosthetic socket during stance phase of gait and to advance the prosthesis to take a step. Sometimes the shortest distances can feel like a marathon or your prosthesis may feel like a ton of bricks. Good news is you have the tools to overcome these sensations!

During this educational series, you will be introduced to a different technique to add to your growing resources. Some may sound familiar; this is a good thing as we all benefit from helpful reminders. Each tool plays a role in increasing your energy so you may feel empowered to do more. 

PELVIC TILT EXERCISE

Let’s start with the basics: Pelvic Tilt Exercise, the foundation to stabilizing your pelvis for proper posture, exercise, lifting, using your prosthesis and more.² This exercise can be modified based on your level of amputation.

Lay on your back with your hips bent. With your prostheses on or off, ensure your lower extremities are supported (e.g. pillow under residual limbs; prosthetic foot on bed/floor). Contract your abdominal muscles by flattening your low back/depressing your belly button. Hold for a count of 5 while slowly breathing. Repeat 20 times. Find yourself slouching throughout the day, try this in sitting or standing, too. The more you do it, the more intuitive it will become.

You may be thinking, “That’s it?”. My answer is, “Yes!”. It may seem simplistic, but you’d be surprised how often individuals do not engage their core while performing physical activity leading to a host of problems.  Back pain is one of the most common issues found in those seeking emergency services and is the most frequent secondary impairment impacting individuals following limb loss.^3,4  Master this foundational exercise and you will be set up for success not only with the activities in this educational series, but with all of your daily activities. Sound stability lends to safe, effective, dynamic mobility.

Stay tuned for the next entry…

References

1. van Schaik, Loeke et al. “Metabolic costs of activities of daily living in persons with a lower limb amputation: A systematic review and meta-analysis.” PloS one vol. 14,3 e0213256. 20 Mar. 2019, doi:10.1371/journal.pone.0213256
2. Wilhoite, Sydni, , et al. “Rehabilitation, Guidelines, and Exercise Prescription for Lower Limb Amputees”. Strength and Conditioning Journal, vol. 42, no. 2, April 2020, pp. 95-102. doi: 10.1519/SSC.0000000000000523.
3. Casiano VE, Sarwan G, Dydyk AM, et al. Back Pain. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538173/