K2 Amputees Can Improve Gait Symmetry with Some K3 Feet

After measuring gait differences before and after gait training with four types of prosthetic feet, a research team led by Vibhor Agrawal, PhD, ATP, assistant professor in the Department of Physical Therapy in the University of Miami Miller School of Medicine, Florida, concluded that improved gait symmetry is possible for K2 amputees who are trained to use K3 prosthetic feet designs.

The study, "Influence of Gait Training and Prosthetic Foot Category on External Work Symmetry during Unilateral Transtibial Amputee Gait," was published online on January 30 in the journal Prosthetics and Orthotics International.

The researchers evaluated five subjects with K2-level unilateral transtibial amputations and five subjects with K3-level unilateral transtibial amputations to determine the influence of gait training on kinetics, the physical work required to walk with a prosthesis, and the level of gait symmetry between each participant's sound-side leg and his or her amputated leg.

The researchers evaluated the influence of gait training with four categories of prosthetic feet: K1, K2, K3, and a microprocessor ankle/foot. The subjects were tested using their existing prosthesis during the first session and again after two weeks of standardized gait training. In sessions three through six, the participants were tested using a study socket and one of four randomized test feet. There was an accommodation period of ten to 14 days with each foot. Kinetic gait differences between prosthetic feet were calculated at each session to determine the gait symmetry at self-selected walking speeds.

The researchers concluded that gait training can improve gait dynamics and that K2 amputees can achieve greater work symmetry with a K3 foot with a J-shaped ankle and heel-to-toe footplate, potentially impacting prosthetic care and foot prescription by clinicians and reimbursement guidelines by third-party healthcare payers.