Does long-distance walking improve or deteriorate walking stability of transtibial amputees?

Background Falls are common in transtibial amputees which are linked to their poor stability. While amputees are encouraged to walk more, they are more vulnerable to fatigue which leads to even poorer walking stability. The objective of this study was to evaluate the dynamic stability of amputees after long-distance walking. Methods Six male unilateral transtibial amputees (age: 53 (SD: 8.8); height: 170 cm (SD: 3.4); weight: 75 kg (SD: 4.7)) performed two sessions (30 minutes each) of treadmill walking, separated by a short period of gait tests. Gait tests were performed before the walking (baseline) and after each session of treadmill walking. Gait parameters and their variability across repeated steps at each of the three conditions were computed. Findings There were no significant differences in walking speed, step length, stance time, time of occurrence, and magnitude of peak angular velocities of the knee and hip joint (P > 0.05). However, variability of knee and hip angular velocity after 30-minute walking was significantly higher than the baseline (P < 0.05) and after a total of 60-minute walking (P < 0.05). The variability of lateral sway velocity after 30-minute walking was significantly higher than the baseline (P < 0.05). Interpretation The significant increase in variability after 30-minute walking could indicate poorer walking stability when fatigue was developed, while the significant reduction after 60-minute walking might indicate the ability of amputees to restore their walking stability after further continuous walking.