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Rehabilitation of persons with lower-limb amputation is a complex endeavor that requires the consideration of a multitude of factors. This article provides an overview of the current practice of prosthesis prescription, mobility training, and the utilization of wheeled mobility options in the clinical care for this population. Recent technological advancements have helped fit persons with lower-limb amputation with more functional, better fitting, and less activity-limiting artificial limbs and wheelchairs. This is exemplified in modern computer-controlled prosthetic components and biomechanically optimized socketfitting methods, as well as light weight and versatile wheelchairs to supplement or replace prosthetic devices. In the research setting, technology has enabled new approaches to the kinematic and kinetic assessment of prosthetic interventions, and the development of more accurate fitting and evaluation methods. Despite the noted progress in the field, there is still a considerable gap between the functionality of a sound leg and even the most advanced prosthesis. It can be predicted that continued research efforts will be undertaken to further close this gap.

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Introduction The quality of lower-limb prosthetic alignment cannot easily be measured directly but may be described by its effects on gait comfort and efficiency. It is known that gait stability and step variability are correlated, as are gait stability and prosthetic alignment. This study investigated the hypothesis that prosthetic alignment and step variability are correlated. This would have the implication that step variability can be measured to assess the quality of prosthetic alignment (and possibly other relevant factors such as prosthetic fit and componentry selection). Materials and Methods Twelve experienced users of transtibial prostheses were subjected to a protocol that introduced malalignments of their prosthetic ankle plantarflexion angle in a randomized crossover design. Perceived alignment quality was recorded via a visual analog scale. Step-by-step variability in horizontal ground reaction forces and axial ankle torsion moment was measured using a prosthesis-integrated load cell and was statistically compared with the degree of misalignment by bivariate correlation analysis. Results Findings suggest that variance in axial torsion moment and step duration may be correlated to alignment quality. Conclusions Subjective patient feedback is the recommendable criterion for alignment assessment in active and experienced users of prostheses. Further research is recommended before step variance may help assess prosthetic alignment quality in patients with less experience in prosthetic use.