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Cadence, energy expenditure, and gait symmetry during music-prompted and self-regulated walking in adults with unilateral transtibial amputation

Rowe, David A. and McMinn, David and Peacock, Leslie and Buis, Adrianus W. P. and Sutherland, Rona and Henderson, Emma and Hewitt, Allan (2014) Cadence, energy expenditure, and gait symmetry during music-prompted and self-regulated walking in adults with unilateral transtibial amputation. Journal of Physical Activity and Health, 11 (2). pp. 320-329. ISSN 1543-3080

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Abstract

Walking cadence has shown promise for estimating walking intensity in healthy adults. Auditory cues have been shown to improve gait symmetry in populations with movement disorders. We investigated the walking cadence-energy expenditure relationship in unilateral transtibial amputees (TTAs), and the potential of music cues for regulating walking cadence and improving gait symmetry. Seventeen unilateral TTAs performed two 5-min treadmill walking trials, followed by two 5-min overground walking trials (self-regulated “brisk” intensity, and while attempting to match a moderate-tempo digital music cue). Walking cadence significantly (P<.001) and accurately (R2=.55, SEE=0.50 METs) predicted energy expenditure, and a cadence of 86 steps·min-1 was equivalent to a 3-MET intensity. Although most participants were able to match cadence to prescribed music tempo, gait symmetry was not improved during the music-guided condition, compared to the self-regulated condition. This is the first study to investigate the utility of walking cadence for monitoring and regulating walking intensity in adults with lower limb prosthesis. Cadence has similar or superior accuracy as an indicator of walking intensity in this population, compared to the general population, and adults with a unilateral TTA are capable of walking at moderate intensity and above for meaningful bouts of time.