Prosthetic alignment is an important factor in the overall fit and performance of a lower-limb prosthesis. However, the association between prosthetic alignment and control strategies used by persons with transfemoral amputation to coordinate the movement of a passive prosthetic knee is poorly understood. This study investigated the biomechanical response of persons with transfemoral amputation to systematic perturbations in knee joint alignment during a level walking task. Quantitative gait data were collected for three alignment conditions: bench alignment, 2 cm anterior knee translation (ANT), and 2 cm posterior knee translation (POST). In response to a Participation Follow-Up: The authors do not plan to inform participants of the publication of this study. However, participants have been encouraged to check the Northwestern University Prosthetics-Orthotics Center Web site for updated publications related to the program's activities, which include the present study.
Disclaimer:The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the VA or the U.S. Government.
U.S. Department of Veterans AffairsPublic Access Author manuscript J Rehabil Res Dev. Author manuscript; available in PMC 2017 August 17.
VA Author ManuscriptVA Author Manuscript VA Author Manuscript destabilizing alignment perturbation (ANT), subjects significantly increased their early-stance hip extension moment, confirming that persons with transfemoral amputation rely on a hip extensor strategy to maintain knee joint stability. However, subjects also decreased the rate at which they loaded their prosthesis, decreased their step length, increased their trunk flexion, and maintained their limb in a more vertical posture at the time of opposite toe off. Collectively, these results suggest that persons with transfemoral amputation rely on a combination of strategies to coordinate stance-phase knee flexion. Further, no significant changes were observed in response to the POST condition, suggesting that a bias toward posterior alignment may have fewer implications in terms of stance-phase, knee-joint control.