ABSTRACTThe purpose of this study was to examine the physiological responses to over-ground (OG) versus treadmill (TM) walking in tibial limb salvage (TLS) patients with comparisons to transtibial (below-knee) amputees. The participants included five TLS (age = 39.2 ± 10.2 yrs, weight = 91.4 ± 11.6 lbs) and five transtibial (age = 37.6 ± 14.1 yrs, weight = 99.2 ± 11.8 lbs) subjects. A multiple-speed (53.6, 67.1, 80.5 and 93.9 m/min = 2.0, 2.5, 3.0 and 3.5 mph) repeated-measures design was used. Results showed mean increases in exercise intensity (a 3.1-percent increase in APMHR) and energy cost (an 11.7-percent VO2increase) and a decrease in gait efficiency (an 11-percent Geff decrease) for TM versus OG walking.Although comparisons between groups were not statistically significant, trends suggested a more impaired gait for TLS subjects than for transtibial subjects. The question of whether severe tibial fracture patients should undergo lengthy limb salvage procedures, which may involve multiple surgeries, long hospital stays and prolonged rehabilitation periods, remains unresolved. Additional research in this area will further assist the prosthetist and surgeon in answering questions involved in decisions surrounding elective amputation.