Kinematic and biomimetic assessment of a hydraulic ankle/foot in level ground and camber walking

PLoS One. 2017 Jul 13;12(7):e0180836. doi: 10.1371/journal.pone.0180836. eCollection 2017.

Abstract

Improved walking comfort has been linked with better bio-mimicking of the prosthetic ankle. This study investigated if a hydraulic ankle/foot can provide enough motion in both the sagittal and frontal planes during level and camber walking and if the hydraulic ankle/foot better mimics the biological ankle moment pattern compared with a fixed ankle/foot device. Five active male unilateral trans-femoral amputees performed level ground walking at normal and fast speeds and 2.5° camber walking in both directions using their own prostheses fitted with an "Echelon" hydraulic ankle/foot and an "Esprit" fixed ankle/foot. Ankle angles and the Trend Symmetry Index of the ankle moments were compared between prostheses and walking conditions. Significant differences between prostheses were found in the stance plantarflexion and dorsiflexion peaks with a greater range of motion being reached with the Echelon foot. The Echelon foot also showed significantly improved bio-mimicry of the ankle resistance moment in all walking conditions, either compared with the intact side of the same subject or with the "normal" mean curve from non-amputees. During camber walking, both types of ankle/foot devices showed similar changes in the frontal plane ankle angles. Results from a questionnaire showed the subjects were more satisfied with Echelon foot.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Amputees / rehabilitation*
  • Ankle / physiopathology*
  • Artificial Limbs
  • Biomechanical Phenomena
  • Biomimetics / instrumentation*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Range of Motion, Articular
  • Surveys and Questionnaires
  • Walking / physiology*

Grants and funding

Xuefei Bai was supported by Henry Lester Trust Ltd. for her doctoral research and publication. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors would like to thank Blatchford & Sons Ltd. for supplying the two types of prosthetic ankles/feet used in this research and for providing prosthetists to help with the fitting of the prosthetic ankles/feet to the subjects. Blatchford & Sons Ltd. did not participant in study design, data collection and analysis, decision to publish, or preparation of the manuscript.