Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 839 — 852

Abstract — The effects of prosthetic ankle stiffness on stability of gait in people with transtibial amputation

Matthew J. Major, PhD;1–2* Martin Twiste, PhD;2–3 Laurence P. J. Kenney, PhD;2 David Howard, PhD2

1Northwestern University Prosthetics-Orthotics Center, Chicago, IL; and Jesse Brown Department of Veterans Affairs Medical Center, Chicago, IL; 2Centre for Health Sciences Research, University of Salford, Salford, UK; 3United National Institute for Prosthetics & Orthotics Development, University of Salford, Salford, UK

Abstract — The ability to control balance during walking is a critical precondition for minimizing fall risk, but this ability is compromised in persons with lower-limb absence because of reduced sensory feedback mechanisms and inability to actively modulate prosthesis mechanical function. Consequently, these individuals are at increased fall risk compared with nondisabled individuals. A number of gait parameters, including symmetry and temporal variability in step/stride characteristics, have been used as estimates of gait stability and fall risk. This study investigated the effect of prosthetic ankle rotational stiffness on gait parameters related to walking stability of transtibial prosthesis users. Five men walked with an experimental prosthesis that allowed for independent modulation of plantar flexion and dorsiflexion stiffness. Two levels of plantar flexion and dorsiflexion stiffness were tested during level, uphill, and downhill walking. The results demonstrate that low plantar flexion stiffness reduced time to foot-flat, which was associated with increased perceived stability, while low dorsiflexion stiffness demonstrated trends in temporal-spatial parameters that are associated with improved gait stability (reduced variability and asymmetry). Prosthesis design and prescription for low rotational stiffness may enhance gait safety for transtibial prosthesis users at risk of unsteadiness and falls.

Key words: amputation, below-knee, biomechanics, foot, gait, prosthesis, stability, stiffness, symmetry, variability.

View HTML ¦ View PDF ¦ Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Major MJ, Twiste M, Kenney LPJ, Howard D. The effects of prosthetic ankle stiffness on stability of gait in people with transtibial amputation. J Rehabil Res Dev. 2016;53(6):839–52.
ORCID: Matthew J. Major, PhD: 0000-0002-2330-4619; Laurence P. J. Kenney, PhD: 0000-0003-2164-3892; Martin Twiste, PhD: 0000-0003-2724-3283

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