0) Amputation Level TTA 60 (51) -- TFA 32 (27) -- BTTA 12 (10) -- BTFA
7 (6) -- TTA/TFA 7 (6) -- Military Status -- Awaiting Disposition 42 (36) -- Active Duty--Nondeployed 32 (27) -- Retired from Armed Forces 44 (37) -- BTFA
= bilateral transfemoral amputation, BTTA = bilateral transtibial amputation, SD = standard deviation, TFA = unilateral transfemoral amputation, TTA = unilateral transtibial amputation.
We found that SMs with BTFA were physically unable to perform the two items that required participants to rise from a chair without the use of upper-limb support.
We observed that not all SMs with BTFA and TTA/TFA were able to immediately achieve quiet standing without taking small steps to adjust base of support and make minor accommodations for the relationship between the proximal socket, bordering anatomy, and clothing.
Upper-limb assistance is essential for those with BTFA and TTA/TFA to control descent into a chair because this task requires an eccentric contraction of the knee extensors to control knee flexion.
Those with BTFA were unable to perform this task without upper-limb support because of the absence of intact knee extensors, as previously discussed.
BTFA results in the loss of bilateral ankle and knee power and postural stabilization, which alters joint movement, resulting in compensatory strategies for balance, mobility, and functional tasks.
With the modified AMP scoring, BTFA and TTA/ TFA were no longer penalized for using adaptive mobility strategies such as using upper-limb assistance when rising from a chair or taking a step during immediate standing.
This further validates the adjustments in AMP scores for those with TTA/TFA and BTFA.
Participants with TTA/TFA and BTFA who are missing osseous structures and lower limb musculature have limited ability to generate muscle power and maintain balance during high-level mobility.
reported that individuals with BTFA ambulated at a self-selected walking speed that was 72 percent slower and required 300 percent greater energy cost per unit distance than those without amputation .
Furthermore, the BLLA (BTTA, BTFA, and TTA/ TFA) participants were collapsed together in order to establish comparable regression models with the other amputation levels.
Bilateral Amputation Level BTTA = 2, TTA/TFA = 1, BTFA = 0.