People with unilateral transtibial amputation (uTTA) using a passive-elastic prosthesis typically walk with contact time (t c ) and first and second peak vertical ground reaction force (F 1 and F 2 ) asymmetry and greater first peak external knee adduction moment in their unaffected versus affected leg. A previous study found that use of stance-phase powered prosthesis (BiOM) at a recommended power setting compared to a passive-elastic prosthesis can reduce t c asymmetry at self-selected speed and unaffected leg first peak external knee adduction moment at 1.50–1.75 m/s. However, the BiOM includes a passive-elastic prosthesis that can have different stiffness categories and can be tuned to different power settings, which may affect t c and F 1 and F 2 asymmetry and unaffected leg first peak external knee adduction moment. Thirteen people with uTTA used 16 different passive-elastic prosthetic foot stiffness categories and BiOM power settings to walk at 0.75–1.75 m/s. We found that use of the stiffest compared to least stiff category reduced F 2 asymmetry. Use of the BiOM reduced t c asymmetry compared to a passive-elastic prosthesis and the effects of power setting on F 1 and F 2 asymmetry depended on walking speed. To minimize biomechanical asymmetry during walking at 1.25 m/s, people with uTTA should use the BiOM with power settings up to 20% greater than those that match biological ankle joint biomechanics. Such prosthetic settings could potentially reduce unaffected leg joint pain and/or osteoarthritis risk.
Tacca et al. (Wed,) studied this question.
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