A more compliant prosthetic foot better accommodates added load while walking among Servicemembers with transtibial limb loss

JOURNAL OF BIOMECHANICS

卷:98

Article

Schnall, Barri L.¹  Dearth, Christopher L.^1,2,3  Elrod, Jonathan M.¹  Golyski, Pawel R.¹  Koehler-McNicholas, Sara R.^4,5  Ray, Samuel F.¹  Hansen, Andrew H.^4,5  Hendershot, Brad D.^1,2,6 

[1] Walter Reed Natl Mil Med Ctr, Dept Rehabil, Res & Dev Sect, 4494 N Palmer Rd,Amer Bldg 19,Room 8320, Bethesda, MD 20889 USA

[2] DoD VA Extrem Trauma & Amputat Ctr Excellence, Bethesda, MD USA

[3] Uniformed Serv Univ Hlth Sci, Dept Surg, Bethesda, MD 20814 USA

[4] Minneapolis Dept Vet Affairs Hlth Care Syst, Minneapolis, MN USA

[5] Univ Minnesota, Dept Rehabil Med, Div Rehabil Sci, Minneapolis, MN USA

[6] Uniformed Serv Univ Hlth Sci, Dept Rehabil Med, Bethesda, MD 20814 USA

关键词: Extremity trauma;    Ankle-foot prosthesis;    Load carriage;    Biomechanics;   

DOI  :  10.1016/j.jbiomech.2019.109395

来源: Elsevier

【 摘 要 】

Selecting an optimal prosthetic foot is particularly challenging for highly active individuals with limb loss, such as military personnel, who need to seamlessly perform a variety of demanding activities/tasks (often with and without external loads) while minimizing risk of musculoskeletal injuries over the longer term. Here, we expand on prior work by comparing biomechanical and functional outcomes in two prosthetic feet with the largest differences in mechanical response to added load (i.e., consistently Compliant and Stiff forefoot properties). In each foot, fourteen male Servicemembers with unilateral transtibial limb loss (from trauma) completed instrumented gait analyses in all combinations of two loading conditions (with and without 22 kg weighted vest) and two walking speeds (1.34 and 1.52 m/s), as well as the Prosthesis Evaluation Questionnaire. With the Stiff foot, sound limb peak loading was 2% smaller (p = 0.043) in the loaded versus unloaded condition, but similar between loading conditions in the Compliant foot (note, the Stiff foot was associated with larger loads, overall). Independent of load or walking speed, the Compliant (versus Stiff) foot provided 67.9% larger (p < 0.001) prosthetic push-off, 17.7% larger (p = 0.01) roll-over shape radii, and was subjectively favored by 10 participants. A more Compliant versus Stiff prosthetic foot therefore appears to better accommodate walking with and without added load, and reinforce the notion that mechanical properties of prosthetic feet should be considered for near-term performance and longer-term (joint) health. Published by Elsevier Ltd.

【 授权许可】

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