@article{ref1,
title="Toe clearance when walking in people with unilateral transtibial amputation: effects of passive hydraulic ankle",
journal="Journal of rehabilitation research and development",
year="2014",
author="Johnson, Louise and De Asha, Alan R. and Munjal, Ramesh and Kulkarni, Jai and Buckley, John G.",
volume="51",
number="3",
pages="429-438",
abstract="Most clinically available prosthetic feet have a rigid attachment or incorporate an &quot;ankle&quot; device allowing elastic articulation during stance, with the foot returning to a &quot;neutral&quot; 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 &quot;toes down&quot; 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.<p /> <p>Language: en</p>",
language="en",
issn="0748-7711",
doi="10.1682/JRRD.2013.05.0126",
url="http://dx.doi.org/10.1682/JRRD.2013.05.0126"
}