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

Objective: To compare energy cost of walking (ECW) and prosthesis-related perceived mobility with the Marlo Anatomical Socket (MAS ^®) and the Ischial Containment (IC) Socket. Method: 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. Results: 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). Conclusion: 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.