Therapeutic benefits of lower limb prostheses: a systematic review.
Elke Lathouwers, María Alejandra Díaz, Alexandre Maricot and 5 others
PMID 36639655WHAT IT FOUND
Switching from standard passive prosthetic feet to advanced quasi-passive or active models improved walking mechanics and energy efficiency in the short term.
However, the evidence is weak, mostly limited to brief lab tests, and no studies examined long-term health outcomes or quality of life.
Key findings
01Advanced prostheses (quasi-passive and active) showed short-term improvements in biomechanical measures compared to passive devices, though all studies also reported some null or unfavourable effects.
02No included study examined the long-term therapeutic benefits of these prostheses, and familiarisation time was short (mean 11 days).
03Subjective measures of quality of life were rarely used, with only 29% of studies assessing this dimension.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
High risk of bias across included studies, primarily due to lack of randomisation and inability to blind participants to prosthetic type. Short familiarisation times (mean 11 days) may not reflect real-world adaptation or long-term benefits. Most studies involved people with transtibial amputations, limiting generalisability to those with transfemoral amputations. Subjective quality of life measures were rarely used, and no studies assessed long-term outcomes or secondary injuries. Small sample sizes in individual studies (often fewer than 10 participants) reduce the reliability of findings.
Declared interests
The paper states it was supported by non-US government funding. No specific commercial conflicts of interest or funding by prosthetic manufacturers are detailed in the provided text.
The easy way to misread this
Do not interpret these short-term biomechanical improvements as evidence that advanced prostheses will enhance long-term quality of life or prevent secondary health issues. The review found no long-term data, and subjective benefits were inconsistent and poorly measured.