Citation

Johnson L, De Asha AR, Munjal R, Kulkarni J, Buckley JG. J. Rehabil. Res. Dev. 2014; 51(3): 429-438.

Affiliation

Division of Medical Engineering, School of Engineering, and Division of Allied Health Professions, School of Health Studies, University of Bradford, Bradford, United Kingdom.

Copyright

(Copyright © 2014, Rehabilitation Research and Development Service, U.S. Department of Veterans Affairs)

DOI

10.1682/JRRD.2013.05.0126

PMID

25019665

Abstract

Most clinically available prosthetic feet have a rigid attachment or incorporate an "ankle" device allowing elastic articulation during stance, with the foot returning to a "neutral" position at toe-off. We investigated whether using a foot with a hydraulically controlled articulating ankle that allows the foot to be relatively dorsiflexed at toe-off and throughout swing would increase minimum toe clearance (MTC). Twenty-one people with unilateral transtibial amputation completed overground walking trials using their habitual prosthetic foot with rigid or elastic articulating attachment and a foot with a hydraulic ankle attachment (hyA-F). MTC and other kinematic variables were assessed across multiple trials. When using the hyA-F, mean MTC increased on both limbs (p = 0.03). On the prosthetic limb this was partly due to the device being in its fully dorsiflexed position at toe-off, which reduced the "toes down" foot angle throughout swing (p = 0.01). Walking speed also increased when using the hyA-F (p = 0.001) and was associated with greater swing-limb hip flexion on the prosthetic side (p = 0.04), which may have contributed to the increase in mean MTC. Variability in MTC increased on the prosthetic side when using the hyA-F (p = 0.03), but this did not increase risk of tripping.

Language: en