The effects of prosthetic ankle stiffness on stability of gait in people with transtibial amputation

Matthew J. Major*, Martin Twiste, Laurence P.J. Kenney, David Howard

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

The ability to control balance during walking is a critical precondition for minimizing fall risk, but this ability is compromised in persons with lower-limb absence because of reduced sensory feedback mechanisms and inability to actively modulate prosthesis mechanical function. Consequently, these individuals are at increased fall risk compared with nondisabled individuals. A number of gait parameters, including symmetry and temporal variability in step/stride characteristics, have been used as estimates of gait stability and fall risk. This study investigated the effect of prosthetic ankle rotational stiffness on gait parameters related to walking stability of transtibial prosthesis users. Five men walked with an experimental prosthesis that allowed for independent modulation of plantar flexion and dorsiflexion stiffness. Two levels of plantar flexion and dorsiflexion stiffness were tested during level, uphill, and downhill walking. The results demonstrate that low plantar flexion stiffness reduced time to foot-flat, which was associated with increased perceived stability, while low dorsiflexion stiffness demonstrated trends in temporal-spatial parameters that are associated with improved gait stability (reduced variability and asymmetry). Prosthesis design and prescription for low rotational stiffness may enhance gait safety for transtibial prosthesis users at risk of unsteadiness and falls.

Original languageEnglish (US)
Pages (from-to)839-852
Number of pages14
JournalJournal of Rehabilitation Research and Development
Volume53
Issue number6
DOIs
StatePublished - 2016

Keywords

  • Amputation
  • Below-knee
  • Biomechanics
  • Foot
  • Gait
  • Prosthesis
  • Stability
  • Stiffness
  • Symmetry
  • Variability

ASJC Scopus subject areas

  • Rehabilitation

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