PTOtherJournal of neuroengineering and rehabilitation2017

Standing on slopes - how current microprocessor-controlled prosthetic feet support transtibial and transfemoral amputees in an everyday task.

Michael Ernst, Björn Altenburg, Malte Bellmann and 1 others

PMID 29145876

WHAT IT FOUND

On 10° slopes, prosthetic feet that fully adapted and locked dorsiflexion let amputees stand in an almost natural manner with load closer to non-amputees.

This small biomechanical study did not test falls, pain, or daily function.

Key findings

01A foot with both sufficient range of motion and an auto-adaptive dorsiflexion stop supported almost natural standing on slopes.

02For transfemoral amputees, enabling the prosthetic knee stance function reduced differences between feet in load distribution on downward slopes; disabling it made foot design matter more.

03Only the Meridium foot met the study's criteria for posture, load distribution, joint angles and torques.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study included only four transtibial and four transfemoral amputees, and the authors state that statistical power was limited. All amputees were K3 or K4, so the findings may not apply to less active people with lower mobility grades. The test only measured standing on 10° slopes, so it cannot show whether these feet help with walking or other movement tasks. The paper does not describe randomization of foot order, and participants chose freely how to stand, which may have affected posture and variability. Prosthetic ankle torques were not directly comparable between feet because the mechanical ankle position differed by foot design. The Elan foot tested had no stance function, and a newer commercially available version had different damping. The Raize foot was not tested in transfemoral amputees, so the comparison is not complete across all feet for that group.

Declared interests

No funding or conflict-of-interest declaration is provided in the supplied text.

The easy way to misread this

Do not read these biomechanical results as proof that a microprocessor-controlled foot reduces falls or improves daily life. The study measured standing on 10° slopes in four transtibial and four transfemoral amputees, and for transfemoral amputees the knee stance function also changed the result.

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