According to the embodiments described herein, a leg actuation system for a patient transport cot comprises a telescoping hydraulic cylinder, a hydraulic pressure source and a carriage. The telescoping hydraulic cylinder comprises a piston and a cylinder housing. The hydraulic pressure source is in fluid communication with the cylinder housing and provides pressurized hydraulic fluid to the telescoping hydraulic cylinder. The carriage is coupled to the telescoping hydraulic cylinder, an amplification rail and a transmission assembly coupled to the amplification rail. The transmission assembly applies forces to the amplification rail to translate the amplification rail away from the carriage a distance that is generally proportional to an extension distance of the piston relative to the cylinder housing.
