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Alignment of a lower limb prosthesis refers to the spatial orientation of the prosthetic components and socket with respect to one another. During the process of dynamic alignment, a prosthetist repeatedly modifies this spatial orientation and observes the amputee's resulting walking pattern, eventually arriving at an alignment that is judged to be optimal. Quantification of the effect of each alignment modification and correlation of the magnitude of modification with the changes in gait could improve understanding of the process and promote an evidential base for practice. This investigation quantified bilateral plantar foot pressures in six trans-tibial amputee subjects during the process of dynamic alignment at prosthetists' clinics during regularly scheduled appointments. Outcomes of changes in prosthetic alignment during the clinical dynamic alignment process were determined to be quantifiable via plantar pedobarography. Changes in the angle between the pylon and the socket in the frontal plane produced predictable shifts in foot pressure between medial and lateral foot regions under the prosthesis, and typically shifted pressure to the lateral region of the contralateral foot, regardless of the direction of the modification. Temporal parameters revealed that subjects initially adopt a conservative locomotor pattern after an alignment change but within a few steps begin to refine their gait and

Sloped walking surfaces provide a unique environment for examining the bio-mechanics and neural control of locomotion. While sloped surfaces have been used in a variety of studies in recent years, the current literature provides little if any discussion of the integrity, i.e., validity, of the systems used to collect data. The goal of this study was to develop and characterize a testing system capable of evaluating the kinetics of human locomotion on sloped surfaces. A ramped walkway system with an embedded force plate was constructed and stabilized. Center of pressure and reaction force data from the force plate were evaluated at 6 ramp grades (0, 5, 15, 25, 35, and 39%). Ground reaction force data at 0% grade were effectively the same as data from the same force plate when mounted in the ground and were well within the range of intrasubject variability. Collectively, data from all tests demonstrate the fidelity of this ramp system and suggest it can be used to evaluate human locomotion over a range of slope intensities.