The CAT-CAM socket and quadrilateral socket: A comparison of energy cost during ambulation

R. S. Gailey, D. Lawrence, C. Burditt, P. Spyropoulos, C. Newell, M. S. Nash

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


Twenty unilateral trans-femoral amputees fitted with either the Contoured Adducted Trochanteric-Controlled Alignment Method (CAT-CAM) socket (n=10) or the quadrilateral (QUAD) socket (n=10), and a "non-amputee" control group (n=10) participated in the study. Subjects meeting the following criteria were studied: healthy males between the ages of 18 and 55 years, amputation due to non-vascular pathology, an unaffected sound limb, at least six months use of the test prosthesis, and a minimal stump length of 15 cm. Subjects ambulated in two randomized trials separated by 20 minutes of rest at 2 assigned speeds: a pace reflecting normal walking speed (97 m/min=2.5 mph) or a slower speed (48.5 m/min=1.25 mph). Heart rate (HR) and Oxygen uptake (VO2) measured during steady state walking were analyzed via two-way ANOVA. Differences among means were further analyzed using Tukey post hoc and simple effects tests. Significant differences were observed between the control group and CAT-CAM subjects with respect to VO2 (p < 0.05) and HR (p < 0.01) at the slower speed. The control group and subjects using the QUAD socket also differed with respect to VO2 (p < 0.01) and HR (p < 0.01) at the slower pace. Faster pace required more energy expenditure (p < 0.01) and produced higher HR (p < 0.01) than slower speeds. At faster pace, a significantly higher energy expenditure in the QUAD than the CAT-CAM group was observed (p<0.01). It is concluded that ambulating at normal pace using the CAT-CAM socket design uses less energy than when using a QUAD socket design.

Original languageEnglish (US)
Pages (from-to)95-100
Number of pages6
JournalProsthetics and orthotics international
Issue number2
StatePublished - Aug 1993

ASJC Scopus subject areas

  • Health Professions (miscellaneous)
  • Rehabilitation


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