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A Below Knee Amputee's (BKA) increased effort to walk

Updated: Jun 1, 2023

🦿When walking Below Knee Amputee energy expenditure has been shown to increase anywhere from 9-25% and in some cases up to 42% (Traugh et al 1975).📚 This is quite a damning result and has been strengthened by many more recent studies.

As you can see there is an incredible variation in energy expenditure. This could seem confusing for some but actually highlights the importance of ones baseline level fitness, function and control. The fitter and stronger you are the better capacity you have to adapt to your amputation and therefore thrive.

As you can see it is imperative to minimise internal factors that can increase the effort of walking.

Muscle weakness

Muscle does not only produce the propulsion to walk it also prevents the loss of power through unnecessary movement. An example would be someone who has significant balance deficits. Their body would be constantly fighting to stay upright and as a result would spend countless amounts of energy fighting to prevent a fall. Therefore it is important to build your strength of:

  • Quads

  • Gluts

  • Hamstrings

  • Trunk or Core

Muscle Length

Tight hip flexors, calves and hamstrings will impact step length and will provide unnecessary resistance


If you have poor balance and control power will be lost from the direction you are trying to travel. For optimum efficiency you want the majority of the power generated to be moving in the direction you desire to travel.


Traugh GH, Corcoran PJ, Reyes RL. Energy expenditure of ambulation in patients with above-knee amputations. Arch Phys Med Rehabil. 1975 Feb;56(2):67-71.

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Written By

Tim Delvins

NDIS Physio Services - Amputee Physio NDIS

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