Article

OBJECTIVE: To determine whether the provision of prosthetic ankle motion improves
walking performance in persons with bilateral transtibial amputations. DESIGN:
Crossover experimental design in which 19 persons with bilateral transtibial
amputations were fitted with Endolite Multiflex Ankles (flexion unit) and Otto
Bock Torsion Adapters (torsion unit) to increase relative motion between the
prosthetic foot and socket in the sagittal and transverse planes, respectively.
Quantitative gait analyses were performed on subjects as they walked with four
prosthetic configurations: baseline without flexion or torsion units, with only
the flexion unit, with only the torsion unit, and with both the flexion and
torsion units. Data were compared with a control group of 14 able-bodied
subjects. RESULTS: The flexion unit increased ankle sagittal plane motion (6-7
degrees) and increased positive ankle power (about 0.17 W/kg). The torsion unit
increased transverse plane ankle range of motion by 1-2 degrees. Responses from
questionnaires indicated that 14 of the 19 subjects preferred the prosthetic
configuration that included both the flexion and torsion units. Further, the
subjects perceived that the increased prosthetic ankle motion was particularly
beneficial for improving stability while they walked on uneven terrain.
CONCLUSIONS: Both the subjective and objective results suggest that prosthetic
foot and ankle components that allow for greater sagittal and transverse plane
rotations provide substantial benefit during walking and should be considered for
persons with bilateral transtibial amputations. Nonetheless, clinicians should
perform individual and appropriate assessments of patients to ensure that they
are capable of using components that may improve mobility while possibly
sacrificing some degree of stability.

Langue : ANGLAIS