Prosthetic energy return during walking increases after 3 weeks of adaptation to a new device.
Samuel F Ray, Shane R Wurdeman, Kota Z Takahashi
PMID 29374491WHAT IT FOUND
After 3 weeks, users of a new passive prosthetic foot walked faster and the prosthesis returned more energy, but the sound limb also worked harder.
Speed increases may explain these changes, and individual responses varied widely, so do not assume uniform adaptation.
Key findings
01Prosthetic positive work increased by 6.1% after 3 weeks of adaptation.
02Sound limb ankle-foot positive work also increased by 5.7%, contrary to the hypothesis that sound limb reliance would decrease.
03Self-selected walking speed increased by 4.1%, and changes in speed were significantly correlated with changes in prosthetic work.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Walking speed was not controlled or matched across visits, so it is unclear if mechanical changes were due to adaptation or simply walking faster. The sample consisted only of experienced prosthesis users (mean 7.5 years post-amputation), limiting generalizability to new amputees. Individual responses varied widely, with some users showing decreased prosthetic work and increased sound limb work. The 3-week period may not represent full adaptation. No gait training or instructions on maximizing energy return were provided.
Declared interests
Funded by the National Institutes of Health. No other conflicts declared.
The easy way to misread this
Do not interpret the increase in prosthetic energy return as evidence that the user has successfully offloaded the sound limb. The sound limb's work also increased, and the changes may be driven by the increase in walking speed rather than specific adaptation to the device.