Joint Moments During Downhill and Uphill Walking of a Person with Transfemoral Amputation with a Hydraulic Articulating and a Rigid Prosthetic Ankle—A Case Study

Abstract

Introduction: Functional characteristics of prosthetic ankle design may facilitate sloped walking for transfemoral amputees. The aim of the current case-study was to analyse the effects of a rigid vs. a hydraulically articulating ankle component on the biological joint moments of a transfemoral amputee during downhill, uphill and level walking. Methods: The gait of one unilateral transfemoral amputee, using the same prosthetic foot with rigid and hydraulic ankle components, was analysed and compared to a control group of 18 able-bodied participants. Kinematic and kinetic data were recorded at self-selected walking speed on a sloped ramp with inclinations of-12°,-4° (downhill), 0° (level), +4° and +12° (uphill). Results: The slope influenced lower limb joint moments similarly in both able-bodied and transfemoral participants. The effect of altering ankle movement through exchanging prosthetic ankle componentry was most acutely seen at the hip joint of the residual limb. The use of a hydraulic ankle joint component resulted in decreased mean hip joint extension and flexion moments of up to 92% and 48% respectively in the residual limb when compared to using the rigid ankle joint component, respectively. Conclusion: During sloped walking, the use of a hydraulically articulating vs. rigid ankle joint component reduced the joint moments observed at the hip joint of the residual limb in a unilateral transfemoral amputee. This indicates a benefit for transfemoral amputees as the increased ankle function reduces the moment producing requirements of the hip joint which may result in decreased energy consumption and subsequently, a more efficient gait.

Exploring the interaction of knee and ankle component use on mobility test performance in people with unilateral transfemoral amputation

“…Furthermore, where MPK components are not available, feasible or desirable, for cost or practicality reasons, the mechanical function of an advanced ankle-foot component, such as the hydraulic ankle-foot components assessed in this study, could also provide additional mobility benefits. 33 This may be of particular use to IUTFs in low resource settings or with multiple options for prosthetic limbs. Of course, the data from this study must be viewed in the context of the ability of the participants recruited.…”