OBJECTIVE: To determine the energy expenditure and subjective comfort rating of walking in transtibial amputee patients using their prosthesis fitted either with or without a tele-torsion device (TT Pylon). DESIGN: Randomized, before-after trial. SETTING: Gait laboratory. PARTICIPANTS: Six men, moderately active, with unilateral transtibial amputation (mean age 39.5 +/- 9.9y). INTERVENTION: Subjects walked on a motorized treadmill using their prosthesis fitted either with (ProsWith) or without (ProsWithout) a TT Pylon. Trials were repeated with subjects walking at speeds 100%, 130%, and 160% of their "normal" pace. MAIN OUTCOME MEASURES: The energy expended (VO2) and subjective comfort rating during each walking trial. RESULTS: VO2 during walking with the prosthesis fitted with the TT Pylon was 5.4% and 9.1% lower than when using the prosthesis without the TT Pylon, at the speeds 130% and 160% of normal, respectively. Findings at the speed 160% greater than normal were significant (p < 0.05). Two of the subjects perceived no difference in prosthetic comfort between ProsWith and ProsWithout. The other 4 subjects preferred the TT Pylon at all speeds. CONCLUSION: Use of a TT Pylon can significantly reduce the energy expenditure of walking at speeds above normal.

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