The Effect of Foot and Ankle Prosthetic Components on Braking and Propulsive Impulses During Transtibial Amputee Gait

Robert J. Zmitrewicz, Richard R. Neptune, Judith G. Walden, William E Rogers, Gordon W. Bosker

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Objective: To assess the influence of energy storage and return (ESAR) prosthetic feet and multi-axis ankles on ground reaction forces and loading asymmetry between lower limbs in transtibial amputees. Design: Subjects wore 2 different prosthetic feet with and without a multi-axis ankle and were analyzed using a blind repeated-measures multivariate analysis-of-variance design. Setting: Gait analysis laboratory. Participants: Fifteen healthy unilateral transtibial amputees (>55y) who had an amputation at least 1 year before testing because of vascular disorders. Interventions: Not applicable. Main Outcome Measures: The anteroposterior ground reaction force impulse, peak ground reaction forces, and braking and propulsion impulse duration were analyzed as subjects walked at a self-selected speed while wearing each of the 4 foot-ankle prosthesis combinations. Statistical analyses were used to determine if there was a significant foot, ankle, or foot-ankle interaction effect on the outcome measures for each foot (P<.05). Results: Amputees generated a significantly greater propulsive impulse with the residual leg when wearing a multi-axis ankle with the ESAR and non-ESAR foot, which improved the propulsive symmetry between the residual and intact legs. There was no prosthetic foot effect on these measures. There were no significant differences in the peak residual-leg braking or propulsive ground reaction forces or the impulse durations due to the prosthetic foot, ankle, or foot-ankle interactions, although an increase in the propulsive impulse duration approached significance (P=.062) with a multi-axis ankle. Conclusions: These results suggest that amputee gait may improve with the prescription of multi-axis ankles that allow for greater propulsive impulses by the residual leg, which improve the loading symmetry between legs.

Original languageEnglish (US)
Pages (from-to)1334-1339
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume87
Issue number10
DOIs
StatePublished - Oct 2006

Fingerprint

Amputees
Gait
Ankle
Foot
Leg
Outcome Assessment (Health Care)
Amputation
Prostheses and Implants
Prescriptions
Blood Vessels
Lower Extremity
Analysis of Variance
Healthy Volunteers
Multivariate Analysis

Keywords

  • Amputees
  • Rehabilitation
  • Walking

ASJC Scopus subject areas

  • Rehabilitation

Cite this

The Effect of Foot and Ankle Prosthetic Components on Braking and Propulsive Impulses During Transtibial Amputee Gait. / Zmitrewicz, Robert J.; Neptune, Richard R.; Walden, Judith G.; Rogers, William E; Bosker, Gordon W.

In: Archives of Physical Medicine and Rehabilitation, Vol. 87, No. 10, 10.2006, p. 1334-1339.

Research output: Contribution to journalArticle

Zmitrewicz, Robert J. ; Neptune, Richard R. ; Walden, Judith G. ; Rogers, William E ; Bosker, Gordon W. / The Effect of Foot and Ankle Prosthetic Components on Braking and Propulsive Impulses During Transtibial Amputee Gait. In: Archives of Physical Medicine and Rehabilitation. 2006 ; Vol. 87, No. 10. pp. 1334-1339.
@article{84dd3a217ade464a9c3decd97777db7f,
title = "The Effect of Foot and Ankle Prosthetic Components on Braking and Propulsive Impulses During Transtibial Amputee Gait",
abstract = "Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Objective: To assess the influence of energy storage and return (ESAR) prosthetic feet and multi-axis ankles on ground reaction forces and loading asymmetry between lower limbs in transtibial amputees. Design: Subjects wore 2 different prosthetic feet with and without a multi-axis ankle and were analyzed using a blind repeated-measures multivariate analysis-of-variance design. Setting: Gait analysis laboratory. Participants: Fifteen healthy unilateral transtibial amputees (>55y) who had an amputation at least 1 year before testing because of vascular disorders. Interventions: Not applicable. Main Outcome Measures: The anteroposterior ground reaction force impulse, peak ground reaction forces, and braking and propulsion impulse duration were analyzed as subjects walked at a self-selected speed while wearing each of the 4 foot-ankle prosthesis combinations. Statistical analyses were used to determine if there was a significant foot, ankle, or foot-ankle interaction effect on the outcome measures for each foot (P<.05). Results: Amputees generated a significantly greater propulsive impulse with the residual leg when wearing a multi-axis ankle with the ESAR and non-ESAR foot, which improved the propulsive symmetry between the residual and intact legs. There was no prosthetic foot effect on these measures. There were no significant differences in the peak residual-leg braking or propulsive ground reaction forces or the impulse durations due to the prosthetic foot, ankle, or foot-ankle interactions, although an increase in the propulsive impulse duration approached significance (P=.062) with a multi-axis ankle. Conclusions: These results suggest that amputee gait may improve with the prescription of multi-axis ankles that allow for greater propulsive impulses by the residual leg, which improve the loading symmetry between legs.",
keywords = "Amputees, Rehabilitation, Walking",
author = "Zmitrewicz, {Robert J.} and Neptune, {Richard R.} and Walden, {Judith G.} and Rogers, {William E} and Bosker, {Gordon W.}",
year = "2006",
month = "10",
doi = "10.1016/j.apmr.2006.06.013",
language = "English (US)",
volume = "87",
pages = "1334--1339",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "10",

}

TY - JOUR

T1 - The Effect of Foot and Ankle Prosthetic Components on Braking and Propulsive Impulses During Transtibial Amputee Gait

AU - Zmitrewicz, Robert J.

AU - Neptune, Richard R.

AU - Walden, Judith G.

AU - Rogers, William E

AU - Bosker, Gordon W.

PY - 2006/10

Y1 - 2006/10

N2 - Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Objective: To assess the influence of energy storage and return (ESAR) prosthetic feet and multi-axis ankles on ground reaction forces and loading asymmetry between lower limbs in transtibial amputees. Design: Subjects wore 2 different prosthetic feet with and without a multi-axis ankle and were analyzed using a blind repeated-measures multivariate analysis-of-variance design. Setting: Gait analysis laboratory. Participants: Fifteen healthy unilateral transtibial amputees (>55y) who had an amputation at least 1 year before testing because of vascular disorders. Interventions: Not applicable. Main Outcome Measures: The anteroposterior ground reaction force impulse, peak ground reaction forces, and braking and propulsion impulse duration were analyzed as subjects walked at a self-selected speed while wearing each of the 4 foot-ankle prosthesis combinations. Statistical analyses were used to determine if there was a significant foot, ankle, or foot-ankle interaction effect on the outcome measures for each foot (P<.05). Results: Amputees generated a significantly greater propulsive impulse with the residual leg when wearing a multi-axis ankle with the ESAR and non-ESAR foot, which improved the propulsive symmetry between the residual and intact legs. There was no prosthetic foot effect on these measures. There were no significant differences in the peak residual-leg braking or propulsive ground reaction forces or the impulse durations due to the prosthetic foot, ankle, or foot-ankle interactions, although an increase in the propulsive impulse duration approached significance (P=.062) with a multi-axis ankle. Conclusions: These results suggest that amputee gait may improve with the prescription of multi-axis ankles that allow for greater propulsive impulses by the residual leg, which improve the loading symmetry between legs.

AB - Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Objective: To assess the influence of energy storage and return (ESAR) prosthetic feet and multi-axis ankles on ground reaction forces and loading asymmetry between lower limbs in transtibial amputees. Design: Subjects wore 2 different prosthetic feet with and without a multi-axis ankle and were analyzed using a blind repeated-measures multivariate analysis-of-variance design. Setting: Gait analysis laboratory. Participants: Fifteen healthy unilateral transtibial amputees (>55y) who had an amputation at least 1 year before testing because of vascular disorders. Interventions: Not applicable. Main Outcome Measures: The anteroposterior ground reaction force impulse, peak ground reaction forces, and braking and propulsion impulse duration were analyzed as subjects walked at a self-selected speed while wearing each of the 4 foot-ankle prosthesis combinations. Statistical analyses were used to determine if there was a significant foot, ankle, or foot-ankle interaction effect on the outcome measures for each foot (P<.05). Results: Amputees generated a significantly greater propulsive impulse with the residual leg when wearing a multi-axis ankle with the ESAR and non-ESAR foot, which improved the propulsive symmetry between the residual and intact legs. There was no prosthetic foot effect on these measures. There were no significant differences in the peak residual-leg braking or propulsive ground reaction forces or the impulse durations due to the prosthetic foot, ankle, or foot-ankle interactions, although an increase in the propulsive impulse duration approached significance (P=.062) with a multi-axis ankle. Conclusions: These results suggest that amputee gait may improve with the prescription of multi-axis ankles that allow for greater propulsive impulses by the residual leg, which improve the loading symmetry between legs.

KW - Amputees

KW - Rehabilitation

KW - Walking

UR - http://www.scopus.com/inward/record.url?scp=33749144474&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33749144474&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2006.06.013

DO - 10.1016/j.apmr.2006.06.013

M3 - Article

C2 - 17023242

AN - SCOPUS:33749144474

VL - 87

SP - 1334

EP - 1339

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 10

ER -