Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “walking pace”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources

Fractional Langevin model of gait variability.

The stride interval in healthy human gait fluctuates from step to step in a random manner and scaling of the interstride interval time series motivated previous investigators to conclude that this time series is fractal. Early studies suggested that gait is a monofractal process, but more recent work indicates the time series is weakly multifractal. Herein we present additional evidence for the weakly multifractal nature of gait. We use the stride interval time series obtained from ten healthy adults walking at a normal relaxed pace for approximately fifteen minutes each as our data set. A fractional Langevin equation is constructed to model the underlying motor control system in which the order of the fractional derivative is itself a stochastic quantity. Using this model we find the fractal dimension for each of the ten data sets to be in agreement with earlier analyses. However, with the present model we are able to draw additional conclusions regarding the nature of the control system guiding walking. The analysis presented herein suggests that the observed scaling in interstride interval data may not be due to long-term memory alone, but may, in fact, be due partly to the statistics.

Journal Article↗

Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. SOLVD Investigators.

OBJECTIVE: To study the potential usefulness of the 6-minute walk test, a self-paced submaximal exercise test, as a prognostic indicator in patients with left ventricular dysfunction. DESIGN: Data were collected during a prospective cohort study, the Studies of Left Ventricular Dysfunction (SOLVD) Registry Substudy. SETTING: Twenty tertiary care hospitals in the United States, Canada, and Belgium. PARTICIPANTS: A stratified random sample of 898 patients from the SOLVD Registry who had either radiological evidence of congestive heart failure and/or an ejection fraction of 0.45 or less were enrolled in the substudy and underwent a detailed clinical evaluation including a 6-minute walk test. Patients were followed up for a mean of 242 days. OUTCOME MEASURES: Mortality and hospitalization. RESULTS: During follow-up, 52 walk-test participants (6.2%) died and 252 (30.3%) were hospitalized. Hospitalization for congestive heart failure occurred in 78 participants (9.4%), and the combined endpoint of death or hospitalization for congestive heart failure occurred in 114 walk-test participants (13.7%). Compared with the highest performance level, patients in the lowest performance level had a significantly greater chance of dying (10.23% vs 2.99%; P = .01), of being hospitalized (40.91% vs 19.90%; P = .002), and of being hospitalized for heart failure (22.16% vs 1.99%; P < .0001). In a logistic regression model, ejection fraction and distance walked were equally strong and independent predictors of mortality and heart failure hospitalization rates during follow-up. CONCLUSION: The 6-minute walk test is a safe and simple clinical tool that strongly and independently predicts morbidity and mortality in patients with left ventricular dysfunction.

Aged↗

Brisk walking speed in older adults who walk for exercise.

OBJECTIVES: To determine the self-selected exercise intensity of older adults who report that they walk briskly for exercise. An additional aim of the study was to assess the contribution of self-reported physical activity to self-selected exercise intensity. DESIGN: Observational. SETTING: walking path. PARTICIPANTS: Subjects consisted of 212 participants in the Study of Physical Performance and Age-Related Changes in Sonomans who stated in a detailed home interview that they walked briskly for exercise. MEASUREMENTS: Observed brisk walking speed was measured as the time it took participants to walk half a mile at "normal brisk walking speed." Self-reported physical activity was categorized as metabolic equivalent of the task (MET) in minutes of exercise reported in the previous 7 days. Physiological measures and body composition were obtained through laboratory evaluation. RESULTS: Men walked at an average speed+/-standard deviation of 5.72+/-0.69 km/h and women walked at an average speed of 5.54+/-0.64 km/h. Self-reported physical activity was not associated with brisk walking speed when adjusted for age and ratio of lean to fat mass. CONCLUSION: This study found that older adults who report that they walk briskly for exercise do so at a pace considered moderate or greater in absolute intensity as indicated by their walking speed (4.83 km/h). Ninety-eight percent of men (93/95) and 97% of women (113/117) had an observed walking speed equivalent to 3 or more METs based on their calculated walking speed.

Aged↗

Comparison of 1-year effects of left ventricular and biventricular pacing in patients with heart failure who have ventricular arrhythmias and left bundle-branch block: the Bi vs Left Ventricular Pacing: an International Pilot Evaluation on Heart Failure Patients with Ventricular Arrhythmias (BELIEVE) multicenter prospective randomized pilot study.

BACKGROUND: Little is known on the chronic effects of left ventricular pacing (LV) in heart failure. METHODS: Seventy-four patients with LBBB, QRS >130 milliseconds, New York Heart Association class (Bradley DJ, Bradley EA, Braughman KL, et al. Cardiac resynchronization and death from progressive heart failure: a meta-analysis of randomized controlled trials. JAMA 2003;289:730-40.) II, LV ejection fraction (LVEF) <35%, and a class I cardioverter/defibrillator indication were implanted with CRT-D devices and were randomized to either LV or biventricular (BiV) pacing. Response (defined as increases of >5 points increase of LVEF and/or > or = 10% 6-minute walking test [6MWT]) between LV and BiV pacing were compared in an attempt to define the number of patients needed to claim noninferiority of LV pacing. In addition, absolute change in LVEF at 12 months in heart failure patients treated with LV pacing was evaluated. The safety of LV pacing was assessed comparing the total number of ventricular arrhythmia episodes, of hospitalizations, and of deaths between the two pacing modes. RESULTS: The percentage of responders was comparable for both groups (LV = 75%, BiV = 70%, P = .788); based on the 95% CI of the difference between the groups, 1100 patients would be needed to claim noninferiority of LV pacing (with a 5% CI lower limit). LV pacing induced siginificant LVEF increase (5.2%, P = .002). These results remained unchanged after performing adjustment analyses. There were no differences in the numbers of ventricular arrhythmias, hospitalizations, and death events between the 2 pacing modes. CONCLUSIONS: At 12 months, percentage of responders to LV pacing was similar to BIV pacing. Furthermore, LV pacing achieved a significant increase of ejection fraction. LV pacing is both safe and feasible.

Aged↗

Effects of aging on the biomechanics of slips and falls.

Although much has been learned in recent decades about the deterioration of muscular strength, gait adaptations, and sensory degradation among older adults, little is known about how these intrinsic changes affect biomechanical parameters associated with slip-induced fall accidents. In general, the objective of this laboratory study was to investigate the process of initiation, detection, and recovery of inadvertent slips and falls. We examined the initiation of and recovery from foot slips among three age groups utilizing biomechanical parameters, muscle strength, and sensory measurements. Forty-two young, middle-age, and older participants walked around a walking track at a comfortable pace. Slippery floor surfaces were placed on the track over force platforms at random intervals without the participants' awareness. Results indicated that younger participants slipped as often as the older participants, suggesting that the likelihood of slip initiation is similar across all age groups; however, older individuals' recovery process was much slower and less effective. The ability to successfully recover from a slip (thus preventing a fall) is believed to be affected by lower extremity muscle strength and sensory degradation among older individuals. Results from this research can help pinpoint possible intervention strategies for improving dynamic equilibrium among older adults.

Accidental Falls↗

Shuttle walking test: a new approach for evaluating patients with pacemakers.

OBJECTIVE: To validate an incremental field walking test, the shuttle walking test, as a means of assessing pacing modes and to aid programming of rate responsive pacemakers. DESIGN: Three separate groups of patients were recruited. Reproducibility (n = 10) of the shuttle walking test was assessed by performing three consecutive tests. Comparison of the shuttle walking test with a 10 min walk was assessed in 20 patients. In the third group (n = 10) patients with rate responsive pacemakers were programmed to either VVI fixed rate 70 beats/min or VVIR with the optimal rate response to show the discriminative value of the test. SETTING: Pacing clinic in a regional cardiothoracic centre. PATIENTS: 30 patients with chronotropic competence and dual chamber pacemakers with varying functional capacity and 10 patients with rate responsive pacemakers. INTERVENTIONS: Continuous haemodynamic monitoring was obtained using an ambulatory nuclear monitor, the Capintec VEST. Two exercise tests either shuttle walking test or 10 min corridor walk. The shuttle walk is an incremental walking test conducted on a 10 m course where the walking speed is dictated by bleeps on an audio cassette. RESULTS: Reproducibility was demonstrated over three consecutive tests with mean (1 SD) exercise times of 7.6 (1.7) min, 7.7 (1.6), and 7.7 (1.7) min. During the shuttle walk the test patients walked for a mean of 8.3 (1.2) min producing peak relative cardiac outputs of 78 (21) end diastolic volume/min compared with 64.9 (17) end diastolic volume/min for the 10 min walk (P < 0.001); peak heart rates were 118 and 104 beats/min (P < 0.03) respectively. In the third group relative peak cardiac output was significantly greater in VVIR (70 (24) v VVI 52 (15) end diastolic volume/min) (P < 0.009) as were exercise times (VVIR 8.8 (1.3) min v VVI 8.1 (1.3) min) (P < 0.003). CONCLUSIONS: The shuttle walk is an easy test to administer, requiring little equipment. It produces a symptom limited maximal performance and will be a useful aid to pacemaker programming as it is reproducible and able to show differences in exercise capacity between pacing modes.

Adult↗

Effects of age-related gait changes on the biomechanics of slips and falls.

A laboratory study was conducted to examine gait changes associated with aging and the effect of these changes on initiation of slips and frequency of falls utilizing newly defined biomechanical parameters of slips and falls. Twenty-eight participants from two age groups (young and old) walked around a circular track at a comfortable pace wearing a safety harness. A slippery floor surface was placed on the walking track over the force plate at random time intervals without the participants' awareness. Synchronized kinetic and kinematic measurements were obtained on both slippery and non-slippery walking surfaces. The results indicated that older participants' horizontal heel contact velocity was significantly faster, step length was significantly shorter, and transitional acceleration of the whole body centre-of-mass (COM) was significantly slower than younger participants. Older participants' initial friction demand, as measured by required coefficient of friction (RCOF), was not significantly different than their younger counterparts. Additionally, older participants slipped longer and faster, and fell more often than younger participants. A comparison of horizontal heel contact velocity for participants who fell with participants who did not fall indicated that, in general, fallers' horizontal heel contact velocity was faster than non-fallers. However, a comparison of RCOF for participants who fell with participants who did not fall suggested that RCOF was not a totally deterministic factor influencing actual fall events. These findings suggest that gait changes associated with aging (especially higher horizontal heel contact velocity and slower transition of the whole body COM) affect initiation of slip-induced falls.

Accidental Falls↗

The effect of everyday exercise on steady state digoxin concentrations.

The purpose of this study was to evaluate the effect of 1 hour of everyday exercise (walking at patient's own pace) on serum digoxin concentrations. Nine white male subjects (ages 58-74) who had been taking the same digoxin dose for greater than 1 month participated. There were three continuous phases: 1 hour of rest, 1 hour of exercise, and a final hour of rest. Serum digoxin concentrations were drawn every 20 minutes. During the first rest period, serum digoxin concentrations rose 30% from the first concentration drawn in the study. After 1 hour of exercise, serum digoxin concentrations fell 26.8% from the last concentration of the first rest period. At the end of the second hour of rest, serum digoxin concentrations increased by 36.6% from the last concentration. Repeated measures analysis of variance demonstrated a significant (P less than .01) change in serum digoxin concentrations. Significant (P less than .01) differences were found between sampling times 0 and 60, 60 and 80, 60 and 100, 60 and 120 and 180 minutes using a paired t-test with Bonferroni correction. A weak correlation (r = 0.74, r2 = 0.55) between percent change in concentrations and age during the exercise phase was found, but there was no correlation between the percent change in concentrations and age during the two immobilization phases. Because significant changes in concentrations occurred during each phase of the study, we conclude that the influence of everyday exercise should be taken into account when interpreting serum digoxin concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

Repeatability of temporospatial gait measures in children using the GAITRite electronic walkway.

OBJECTIVE: To determine the repeatability of selected temporal and spatial gait parameters in healthy children using the GAITRite electronic walkway. DESIGN: Immediate test-retest design. SETTING: Community. PARTICIPANTS: A sample of 57 subjects (age range, 1.3-10.9 y) participated. Subjects were stratified into 3 age groups (1.0 to <4.0 years old, 4.0 to <8.0 years old, 8.0 to <11.0 years old). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects completed 2 barefooted test walks at preferred gait speed. Intraclass correlation coefficient (ICC(1,1)) values, 95% confidence intervals, the Bland-Altman limits of agreement, and coefficient of variation (CV) were calculated. RESULTS: Overall, ICC values ranged from .05 to .93. The amount of clinically relevant error (CV) was acceptable for all gait variables across age groups with the exception of the toe-in/out variables (CV, 46.7%-92.9%) and the heel-to-heel base of support variable (CV, 18.6%-31.5%). CONCLUSIONS: Repeatability of GAITRite measurements to assess temporospatial gait parameters in typically developing children walking at self-selected paces ranged from poor to excellent. Our repeatability data for child subjects between the ages of 1.3 to 10.9 years are comparable to adult data for the same temporospatial gait parameters. We believe that the GAITRite electronic walkway is an emerging clinical tool for assessment of gait in children with and without disabilities.

Child↗

Screw fixation of the syndesmosis: a cadaver model comparing stainless steel and titanium screws and three and four cortical fixation.

We assessed syndesmotic set screw strength and fixation capacity during cyclical testing in a cadaver model simulating protected weight bearing. Sixteen fresh frozen legs with artificial syndesmotic injuries and a syndesmotic set screw made of stainless steel or titanium, inserted through three or four cortices, were axially loaded with 800 N for 225,000 cycles in a materials testing machine. The 225,000 cycles equals the number of paces taken by a person walking in a below knee plaster during 9 weeks. Syndesmotic fixation failure was defined as: bone fracture, screw fatigue failure, screw pullout, and/or excessive syndesmotic widening. None of the 14 out of 16 successfully tested legs or screws failed. No difference was found in fixation of the syndesmosis when stainless steel screws were compared to titanium screws through three or four cortices. Mean lateral displacement found after testing was 1.05 mm (S.D. = 0.42). This increase in tibiofibular width exceeds values described in literature for the intact syndesmosis loaded with body weight. Based on this laboratory study it is concluded that the syndesmotic set screw cannot prevent excessive syndesmotic widening when loaded with a load comparable with body weight. Therefore, we advise that patients with a syndesmotic set screw in situ should not bear weight.

Aged↗

Temporal parameters and patterns of the foot roll over during walking: normative data for healthy adults.

Temporal parameters of the gait cycle and foot roll over in 105 healthy adults (75 women and 30 men aged 16 to 63 years) were collected using foot switches. The subjects walked unobserved at their preferred pace and velocity in a hallway 19 m long and 2.8 m wide. After correction for height, a significant gender influence remained on stance parameters and stride duration. For these adults, age had an effect on the forward tilt of the foot and the double support time only. Differences due to side related only to foot patterning and not stride, stance and swing times. Asymmetry coefficient for temporal parameters of gait cycle and foot roll over revealed the greatest asymmetry in metatarsal head and great toe latency and support. These reference data are considered valid in a laboratory using sensors and signal processing comparable to ours.

Adolescent↗

Exercise prescription using resting heart rate plus 20 or perceived exertion in cardiac rehabilitation.

PURPOSE: For patients starting a cardiac rehabilitation program, exercise intensity often is set 20 beats per minute above the standing resting heart rate (RHR+20) or in a range of 11 to 13 on Borg's Scale for Rating of Perceived Exertion (RPE 11-13). The purpose of this study was to determine the actual exercise intensity, expressed as a percentage of peak oxygen uptake reserve (%VO2R) using these techniques. METHODS: For this study, 11 new referrals to a phase 2 cardiac rehabilitation program voluntarily underwent a symptom-limited exercise test and a field test that consisted of self-paced over-the-ground walking for 10 minutes at levels corresponding to RPE 11-13 and RHR+20. During both tests, gas exchange data were obtained via the Cosmed K4b and heart rate via the Polar monitor. RESULTS: The mean %VO2R at RHR+20 (41.8 +/- 12.3%) and RPE 11-13 (71 +/- 15.3% mL.kg.min) were significantly different. Exercise at RHR+20 resulted in 4 of the 11 patients (36%) exercising at less than 40% VO2R, 6 of the patients (55%) exercising at 40% to 60% VO2R, and 1 of the patients (9%) exercising at more than 60% VO2R. Exercise at RPE 11-13 resulted in 1 of the 11 patients (9%) exercising at less than 40% VO2R, 1 of the patients at exercising at 40% to 60% VO2R (9%), and 9 of the patients (82%) exercising at more than 60% VO2R. CONCLUSIONS: The results of this study indicate that using RHR+20 or RPE 11-13 to prescribe exercise intensity during over-the-ground walking for phase 2 cardiac rehabilitation patients results in substantial intersubject variability and raises questions about the safety and efficacy of these approaches.

Adult↗

Functional MRI predicts memory performance after right mesiotemporal epilepsy surgery.

PURPOSE: Anterior temporal lobe resection (ATR) is a treatment option in drug-resistant epilepsy. An important risk of ATR is loss of memory because mesiotemporal structures contribute substantially to memory function. We investigated whether memory-activated functional MRI (fMRI) can predict postoperative memory loss after anterior temporal lobectomy in right-sided medial temporal lobe epilepsy (MTLE). METHODS: We included 16 patients (10 women) aged 16-54 years. The mean age at epilepsy onset was 12.5 years (range, 1-26 years). The patients' mean Wechsler IQ score was 95.2 (range, 62-125). The activation condition of fMRI consisted of retrieval from long-term memory induced by self-paced performance of an imaginative walk. All but one patient had left-sided speech dominance according to speech-activated fMRI. Outside the scanner, we evaluated the pre- and postoperative visual memory retention by using Rey Visual Design Learning Test. RESULTS: We found a correlation between the preoperative asymmetry index of memory-fMRI and the change between pre- and postsurgical measures of memory retention. Reduced activation of the mesiotemporal region ipsilateral to the epileptogenic region correlated with a favorable memory outcome after right-sided ATR. CONCLUSIONS: In light of the postoperative results, the theoretical implication of our study is that fMRI based on a simple introspective retrieval task measures memory functions. The main clinical implication of our study is that memory-fMRI might replace the invasive Wada test in MTLE by using a simple fMRI paradigm. Predictive power, however, will be studied in larger patient samples. Other studies are required for left-sided MTLE and neocortical epilepsies to assess the clinical usefulness of memory-fMRI.

Adolescent↗

Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report.

Vestibular rehabilitation (VR) is increasingly popular, but few data exist to support enthusiasts' claims of efficacy in improving functional abilities of patients with bilateral vestibular hypofunction (BVH). A double-blind, controlled study of eight subjects (mean, 64 +/- 12 years; seven females, one male) with bilateral vestibular hypofunction was conducted. Subjects in group A received 8 weeks of VR followed by 8 weeks of home VR exercises, whereas those in group B received 8 weeks of control treatment (isometric strengthening exercises) followed by 8 weeks of VR. At the end of 8 weeks, group A walked 8% faster and, during paced gait and stair-climbing, with greater stability, evidenced by a 10% larger maximum moment arm and a 17% decreased double-support duration during gait and stair stance. Group B improved less than 1% during the control treatment. Self-reported Dizziness Handicap Inventory scores did not differ significantly between control and active VR. All subjects improved compared with baseline tests at the 16-week post-test on both functional testing and on the Self-reported Dizziness Handicap Inventory scale. We conclude that in this small sample, VR effectively improved functional, dynamic stability during locomotion, but even strengthening exercises result in self-reported symptomatic improvement.

Aged↗

Epileptic activity influences the lateralization of mesiotemporal fMRI activity.

OBJECTIVE: To identify clinical factors contributing to the lateralization of mesiotemporal memory functions in epilepsy by using memory-activated fMRI. METHODS: Sixty patients aged 16 to 63 years with mesial temporal lobe epilepsy (MTLE) and 20 patients aged 16 to 60 years with extratemporal epilepsy (ETE) due to circumscribed epileptogenic lesions who consecutively underwent presurgical evaluation including continuous video-EEG monitoring and structural MRI examinations were examined. During memory fMRI, the activation condition consisted of retrieval from long-term memory induced by self-paced performance of an imaginative walk through the patient's hometown. On the basis of a previous study, memory lateralization was defined as typical if larger fMRI activation was in the mesiotemporal structures contralateral to the epileptic focus. RESULTS: There were 45 patients with MTLE who had typical memory lateralization (75%), whereas only 9 patients (45%) with ETE exhibited typical memory lateralization (p = 0.013). In MTLE patients, bilateral independent epileptiform discharges occurred more often in the atypical group than in patients with typical memory lateralization (p = 0.015). CONCLUSIONS: The fMRI lateralization of mesiotemporal visuospatial memory functions in patients with mesiotemporal lobe epilepsy (MTLE) is asymmetric: The larger activation usually appears contralateral to the side of the epileptogenic region. These findings occur more often in MTLE; in patients with extratemporal epilepsy, such type of asymmetry is not characteristic. In MTLE patients with bilateral independent epileptiform discharges, this type of asymmetry is also less frequent.

Adolescent↗

Function of the triceps surae during gait. Compensatory mechanisms for unilateral loss.

We studied the gait of a woman who was normal except for surgical excision of the gastrocnemius and soleus muscles. She was able to compensate for nearly all of her abnormalites of gait by excessive lateral pelvic tilt and prolonged quadriceps activity. Her mild disability, as regards gait, consisted of inability to increase walking speeds beyond the normal pacing. However, despite uneven step lengths, she had uniform forward progression. She had excessive dorsiflexion of the ankle and diminished plantar flexion on the involved side even though the retained plantar flexors could provide 38 per cent of her normal plantar flexor strength.

Adult↗

[Indicators of work incapacity in the first year of chronic polyarthritis].

Already in the early phase of rheumatoid arthritis (RA) sick-leave (SL) frequently indicates a severe handicap with respect to work capacity. However, the significance of demographic, disease and work characteristics for SL are not known in early RA. Therefore, the indicators of SL (defied as the history of SL as certified by a physician) were sought in a cross-sectional multicenter study of early RA (< or = 1 year duration). One-hundred-and-thirty-four employed consecutive outpatients fulfilled > or = 4 of 7 ARA 1987 criteria of RA: 85 females (63%), age 50 years (median), disease duration 7 months (median). At the time of the examination 74 of the 134 patients (55%) were on SL because of RA (dependent dichotomous variable of the analyses). In order to identify the most important indicators of SL all variables with p < or = 0.10 in univariate analyses were entered into a multivariate logistic regression (stepwise forward analysis, p < or = 0.10). Parameters included in two different regression models (somatic variable and depression, job characteristics, respectively) were analyzed together in order to find the final model (p < or = 0.05). The following variables were included in the final logistic regression model of SL (p < or = 0.05): higher values of age, pain, and number of swollen joints, frequent overhead work, frequent pressure of time at work. Other indicators of SL in univariate analyses (p < or = 0.10) were not included in the model: male sex, low functional capacity, walking time, control over the pace and activities of work, occupational qualification, elevated ESR and depression. Significant indicators of SL are work conditions, disease activity, pain and age. Thus interventions focusing on the amelioration of the work capacity and thereby on the reduction of SL should concentrate on both the control of the disease and the improvement of the work conditions.

Absenteeism↗

Energy expenditure of trans-tibial amputees during ambulation at self-selected pace.

The purpose of this investigation was two-fold: 1) to compare the metabolic cost (VO2), heart rate (HR), and self-selected speed of ambulation of trans-tibial amputees (TTAs) with those of non-amputee subjects; and 2) to determine whether a correlation exists between either stump length or prosthesis mass and the energy cost of ambulation at the self-selected ambulation pace of TTAs. Subjects were thirty-nine healthy male non-vascular TTAs between the ages of 22 and 75 years (mean +/- sd = 47 +/- 16). All had regularly used their prosthesis for longer than six months and were independent of assistive ambulation devices. Twenty-one healthy non-amputee males aged 27-47 years (31 +/- 6) served as controls. Subjects ambulated at a self-selected pace over an indoor course, with steady-state VO2, HR, and ambulation speed averaged across minutes seven, eight and nine of walking. Results showed that HR and VO2 for TTAs were 16% greater, and the ambulation pace 11% slower than the non-amputee controls. Significant correlations were not observed between stump length or prosthesis mass, and the energy cost of ambulation. However, when the TTA subject pool was stratified on the basis of long and short stump length, the former sustained significantly lower steady-state VO2 and HR than the latter while walking at comparable pace. These data indicate that stump length may influence the metabolic cost of ambulation in TTAs.

Adult↗