Noting that sound side loading is a risk factor for osteoarthritis development in people with unilateral transtibial amputations, a team of researchers set out to describe the biomechanical loading while participants used different ankle/foot prostheses during fast-paced walking.
The researchers conducted a blinded, randomized control trial in a group of 20 K3-K4 ambulators who used a SACH foot prosthesis, a standard energy storage and return foot prosthesis (ESAR), and a novel ESAR foot prosthesis (N-ESAR) in a two-week randomized crossover design. The spatiotemporal and kinetic data of the participants’ fast walking pace were collected, and data was analyzed using a mixed model and one-way analysis of variances and Cohen’s d.
There were minimal changes in the spatiotemporal data between the prosthetic feet. When the participants used the N-ESAR feet, they had a lower peak vertical ground reaction force and external knee adduction moment on the sound side, as well as a higher distal shank power on the prosthetic side.
Overall fast-paced walking resulted in higher sound side loading forces compared with normal-paced walking, the study’s authors concluded. However, use of the N-ESAR prosthesis reduced the biomechanical loading on the participants’ sound sides at a fast pace compared with the ESAR and SACH prostheses.
The percentage change in the biomechanical loading from normal- to fast-paced walking of the N-ESAR foot was also larger compared with the other prostheses, perhaps because of the individuals’ ability to achieve a faster walking pace when using the N-ESAR prosthesis.
The open-access study, “Is biomechanical loading reduced in individuals with unilateral transtibial amputation during fast-paced walking when using different ankle/foot prostheses? A pragmatic randomized controlled trial,” was published in Prosthetics and Orthotics International.
