A study in the Journal of the International Neuropsychological Society evaluated the influence of lower-limb loss on mental workload by assessing neurocognitive measures in individuals with unilateral transtibial amputations compared to those with transfemoral amputations while dual-task walking under varying cognitive demand.

EEG signals were recorded as participants performed a task of varying cognitive demand while being seated or walking (i.e., varying physical demand).

The findings revealed both groups exhibited a similar EEG theta synchrony response as either the cognitive or the physical demand increased. Also, while individuals with transtibial amputations maintained similar performance on the cognitive task during seated and walking conditions, those with transfemoral amputations exhibited slower response times on the cognitive task while walking in comparison to the seated conditions, the study found.

Although all participants were able to recruit neural mechanisms critical for the maintenance of cognitive-motor performance under elevated cognitive or physical demands, the observed differences indicate that walking with a prosthesis while concurrently performing a cognitive task imposes additional cognitive demand in individuals with more proximal levels of amputation.