• Jma Visser, I McCarthy, L Marks, and R C Davis.
• Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands. j.m.a.visser@tudelft.nl
• Prosthet Orthot Int. 2011 Dec 1;35(4):451-8.

BackgroundLittle data have been reported on the factors that are important in bilateral amputee walking ability especially the role of hip strength.Study DesignObservational, case-control study where participants were evaluated at a single point in time.ObjectivesThe 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.MethodsFor 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.ResultsBilateral 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.ConclusionsBilateral 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.

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