Gait quality in prosthesis users is reflected by force-based metrics when learning to walk on a new research-grade powered prosthesis.
Kinsey R Herrin, Samuel T Kwak, Chase G Rock and 1 others
PMID 38370855WHAT IT FOUND
Force-based metrics detected gait improvements after tuning a powered prosthesis, but standard clinical observation scores and overall leg work did not.
The tuning process required approximately 24 iterations to reach a state deemed comfortable by the team and participant.
Key findings
01Tuning significantly increased prosthetic ankle power and work, and improved force symmetry, but did not improve overall leg work.
02The Prosthetic Observational Gait Score (POGS) and Gait Quality Index (GQI) showed no significant differences between tuned and untuned conditions.
03The iterative tuning process required an average of 24 parameter changes before the team deemed the gait visually acceptable and the participant comfortable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Very small sample size (n=7) limits generalizability. Participants were all high-functioning (K3-K4) and experienced with passive feet, so findings may not apply to lower-activity users. Testing was restricted to a fixed speed of 1.0 m/s on a treadmill due to the tethered device, preventing assessment of self-selected speed or overground walking. Acclimation time to each parameter change was short (less than 1 minute), which may not reflect long-term adaptation. No formal statistical comparison was made against the participants' own clinically prescribed passive feet.
Declared interests
Funded by the National Science Foundation (NSF-NRI 1734416). No commercial conflicts of interest were declared.
The easy way to misread this
Do not assume that tuning a powered prosthesis leads to immediate, observable improvements in overall gait quality or walking efficiency. While specific force metrics improved, standard clinical scores like POGS did not change, and overall leg work remained unaffected, indicating that biomechanical optimization does not automatically translate to broader functional gains in this short-term setting.