Altering the tuning parameter settings of a commercial powered prosthetic foot to increase power during push-off may not reduce collisional work in the intact limb during gait.

Only four men with unilateral transtibial amputation were analysed, so it says little about women or other amputation causes. One participant had to be removed because handrail reliance made force data unusable, which is a practical limitation for people who need support to walk. Testing was on a treadmill at 1.1 m/s for 3 minutes per condition, so over-ground walking and longer use may behave differently. Subjects had limited acclimation to the powered foot, and the authors note more training might change how power is used. The prosthesis control scheme was proprietary, and the authors were not told how the tuning settings affected power magnitude or timing. The study did not measure pain, knee osteoarthritis, or long-term clinical outcomes; it measured biomechanical work. The null results for collisional work had lower statistical power, so a real small effect cannot be completely ruled out.

The supplied text does not include a funding or conflicts-of-interest statement. A certified prosthetist fitted the device with a representative from the manufacturer, and the authors had limited access to the proprietary control scheme.

Do not conclude that tuning a powered prosthetic foot to increase push-off work will reduce intact-limb loading or knee osteoarthritis risk. In four analysed men, collisional work did not change across settings and was not correlated with prosthesis push-off work. The study did not test pain or osteoarthritis.