Vacuum level effects on gait characteristics for unilateral transtibial amputees with elevated vacuum suspension

There was no systematic vacuum level effect on gait. Higher vacuum levels, such as 15 and 20 in Hg, were more comfortable and provided some relief to the intact limb, but may also increase the risk of osteoarthritis of the residual limb due to the increased peak external hip and knee adduction moments. Very low vacuum should be avoided because of the negative effects on gait symmetry. A moderate vacuum level at 15 in Hg is suggested for unilateral transtibial amputees with elevated vacuum suspension.