Differentiation between solid-ankle cushioned heel and energy storage and return prosthetic foot based on step-to-step transition cost

Wezenberg, Daphne; Cutti, Andrea Giovanni; Bruno, Antonino; Houdijk, Han

doi:10.1682/jrrd.2014.03.0081

Cited by 37 publications

(52 citation statements)

References 36 publications

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“…Previous studies suggest that user satisfaction with forward walking on level ground may be a consequence of improvements in prosthetic foot design, with newer designs preferred over older solid-ankle cushioned-heel designs. 21,22 However, participants in our study also identified a number of situations in which their current prosthetic feet caused significant difficulties, often with safety implications. Consequently, forward walking may not be the most sensitive test for prosthetic mobility.…”

Section: Discussionmentioning

confidence: 85%

“…Although both the prosthetic users and professionals in this study attributed the participation restrictions to the prosthetic foot, this causal relationship was not systematically evaluated in our study and other factors (e.g., skin integrity, as described in Meulenbelt et al 21 ). Future studies should provide elucidation of the mechanisms or participation restriction to enable stakeholders to overcome barriers to participation.…”

Section: Discussionmentioning

confidence: 96%

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What People Want in a Prosthetic Foot: A Focus Group Study

et al. 2016

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Introduction Most people with lower-limb amputation (LLA) rely on a prosthetic foot for participation at home and in the community. The published literature describes problems with mobility after LLA, yet there have been few published accounts of peoples' participation experiences. The purpose of this study was to increase understanding of the impact of prosthetic feet on participation in the activities of daily life by examining the experience of prosthetic users and professionals. Materials and Methods Users of prosthetic feet and health care professionals who prescribe prosthetic feet were invited to complete a brief online questionnaire before participating in one of five focus groups. Descriptive statistics were used to summarize questionnaire data. Focus group sessions were audio recorded and transcribed. Each transcript was thematically coded independently by four researchers. Emergent themes were discussed, categorized, and cross-referenced. Results Eleven prosthetic foot users (68.8%) and 11 professionals (100%) completed the online questionnaires. Although the prosthetic foot users rated their difficulty with usual activities as none to slight, 36% reported falling within the last 6 months, and 45% indicated that they modified their participation because of the potential for falls. Sixteen prosthetic foot users and 11 health care professionals took part in focus groups. There was a significant overlap in themes discussed by prosthetic foot users and health care professionals. Identified barriers to full participation included the ability to stand for extended periods, navigate in confined spaces, carry heavy objects, and change body posture. Absence of sensory feedback created significant concerns about safety when driving a car, navigating uneven terrain, or climbing ladders. Characteristics of existing prosthetic feet that impact participation included limited durability, lack of waterproofing, and limited range of motion. Current designs limited choices of footwear and created difficulties donning and doffing shoes. Conclusions Participants' reported confidence in forward walking on even ground suggests that current prosthetic feet are well-suited for this limited use. However, they also identified a number of situations in which their current prosthetic feet caused significant difficulties, often with safety implications. While some stories, such as rocks on the sidewalk, are consistent with the literature, other stories describe situations such as ladders and stepstools that are not well documented. Our study highlights the utility of focus groups in identifying previously unrecognized needs and concerns, with significant implications for the design of prosthetic feet. Future studies should include more diverse participants, particularly with regard to age and overall physical health.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 96%

What People Want in a Prosthetic Foot: A Focus Group Study

et al. 2016

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“…Amputees wore their own prostheses with energy storage and return feet, passive elastic feet that provide more propulsion than a solid-ankle cushioned heel foot but less than a powered ankle (Wezenberg et al 2014; Herr, Grabowski, 2012). All amputees had their prostheses for over 6 months before testing.…”

Section: Methodsmentioning

confidence: 99%

Two biomechanical strategies for locomotor adaptation to split-belt treadmill walking in subjects with and without transtibial amputation

Selgrade

Toney

Chang

2017

Journal of Biomechanics

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Locomotor adaptation is commonly studied using split-belt treadmill walking, in which each foot is placed on a belt moving at a different speed. As subjects adapt to split-belt walking, they reduce metabolic power, but the biomechanical mechanism behind this improved efficiency is unknown. Analyzing mechanical work performed by the legs and joints during split-belt adaptation could reveal this mechanism. Because ankle work in the step-to-step transition is more efficient than hip work, we hypothesized that control subjects would reduce hip work on the fast belt and increase ankle work during the step-to-step transition as they adapted. We further hypothesized that subjects with unilateral, trans-tibial amputation would instead increase propulsive work from their intact leg on the slow belt. Control subjects reduced hip work and shifted more ankle work to the step-to-step transition, supporting our hypothesis. Contrary to our second hypothesis, intact leg work, ankle work and hip work in amputees were unchanged during adaptation. Furthermore, all subjects increased collisional energy loss on the fast belt, but did not increase propulsive work. This was possible because subjects moved further backward during fast leg single support in late adaptation than in early adaptation, compensating by reducing backward movement in slow leg single support. In summary, subjects used two strategies to improve mechanical efficiency in split-belt walking adaptation: a CoM displacement strategy that allows for less forward propulsion on the fast belt; and, an ankle timing strategy that allows efficient ankle work in the step-to-step transition to increase while reducing inefficient hip work.

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“…The increased understanding of the mechanisms underlying gait impairments, as described in part A, can assist in the development and evaluation of prosthetic components. Wezenberg et al [4] compared a rigid prosthetic foot to a prosthetic foot that is able to store and return energy. These latter category is able to provide prosthetic ankle and foot push-off to a limited extent.…”

Section: B Influence Of Prosthetic Componentsmentioning

confidence: 99%

WeR5 - Human likeliness as a benchmarker for wearable robotics

Prinsen¹,

Buurke²

2018

EasyChair Preprints

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In recent years benchmarking has become an increasingly important topic for the wearable robotic community. One of the key abilities used during the benchmarking of wearable robots is motion ability. Successful motion ability is achieved once the wearable robot is capable of achieving human-like motion while integrating user controlled volitional movements. This requires an in-depth understanding of the mechanisms underlying commonly observed gait impairments. Only then, a wearable robot can allow the user to make the movements he or she desires while providing support where needed. In this conference contribution we present results of research into the mechanisms underlying gait impairments. We take individuals with a transtibial amputation as an example of unilaterally impaired individuals. These results illustrate how an increased understanding of the gait pattern can assist in the development and evaluation of wearable robots.

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Differentiation between solid-ankle cushioned heel and energy storage and return prosthetic foot based on step-to-step transition cost

Cited by 37 publications

References 36 publications

What People Want in a Prosthetic Foot: A Focus Group Study

What People Want in a Prosthetic Foot: A Focus Group Study

Two biomechanical strategies for locomotor adaptation to split-belt treadmill walking in subjects with and without transtibial amputation

WeR5 - Human likeliness as a benchmarker for wearable robotics

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