Article

Comparative effectiveness of prosthetic feet during ramp ambulation
in unilateral transtibial amputees, who function at different Medicare Functional
Classification Levels, has not been published.
OBJECTIVE: To determine
differences in symmetry in external work between four categories of prosthetic
feet in K-Level-2 and K-Level-3 unilateral transtibial amputees during ramp
ascent and descent. STUDY DESIGN: Randomized repeated-measures trial. METHODS:
Ten subjects completed six testing sessions during which symmetry in external
work was calculated using F-scan in-sole sensors. Between testing sessions 1 and
2, subjects received standardized functional prosthetic training. In Sessions
3-6, subjects tested four feet--solid ankle cushion heel, stationary attachment
flexible endoskeleton, Talux (categories K1, K2, and K3, respectively), and
Proprio-Foot (microprocessor ankle)--using a study socket and had a 10- to 14-day
accommodation period with each foot. RESULTS: During ramp descent, K-Level-2
subjects demonstrated higher symmetry in external work values with Talux and
Proprio-Foot compared to the solid ankle cushion heel foot. K-Level-3 subjects
also had higher symmetry in external work values with the Talux foot than the
solid ankle cushion heel foot. Ramp ascent symmetry in external work values were
not significantly different between feet. CONCLUSIONS: Prosthetic foot category
appears to influence symmetry in external work more during decline walking than
incline walking. K-Level-2 unilateral transtibial amputees achieve greater
symmetry from K3 dynamic response prosthetic feet with J-shaped ankle and
microprocessor ankles while descending ramps. CLINICAL RELEVANCE: The findings
suggest that K-Level-2 unilateral transtibial amputees benefit from K3 dynamic
response prosthetic feet with J-shaped ankle. These results support the
prescription of K3 feet for K-Level-2 amputees who frequently negotiate ramps.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS