ObjectiveUnilateral trans-tibial amputation signifies a challenge to locomotion. Prosthetic ankle-foot units are developed to mimic the missing biological system which adapts push-off power to walking speed in some new prosthetic ankle-foot designs. The first systematic review including the two factors aims to investigate push-off power differences among Solid Ankle Cushion Heel (SACH), Energy Storage And Return (ESAR) and Powered ankle-foot units (PWR) and their relation to walking speed. Data sourcesA literature search was undertaken in the Web of Science, PubMed, IEEE xplore, and Google Scholar databases. The search term included: ampu* AND prosth* AND ankle-power AND push-off AND walking. Study appraisal and synthesis methodsStudies were included if they met the following criteria: unilateral trans-tibial amputees, lower limb prosthesis, reported analysis of ankle power during walking. Data extracted from the included studies were clinical population, type of the prosthetic ankle-foot units (SACH, ESAR, PWR), walking speed, and peak ankle power. Linear regression was used to determine whether the push-off power of different prosthetic ankle-foot units varied regarding walking speed. Push-off power of the different prosthetic ankle-foot units were compared using one-way between subjects' ANOVAs with post hoc analysis, separately for slower and faster walking speeds. Results474 publications were retrieved, 28 of which were eligible for inclusion. Correlations between walking speed and peak push-off power were found for ESAR (r = 0.568, p = 0.006) and PWR (r = 0.820, p = 0.000) but not for SACH (r = 0.267, p = 0.522). ESAR and PLOS ONE | https://doi.org/10.1371/journal.pone. Funding:The funders, Klinikum Bayreuth GmbH (https://klinikum-bayreuth.de/) and Ossur hf. (https://www.ossur.com/?select-default-destination=1), provided support in the form of salaries for authors R.M., L.M., R.A. and K.L., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of PWR demonstrated significant differences in push-off power for slower and faster walking speeds (ESAR (p = 0.01) and PWR (p = 0.02)). ConclusionPush-off power can be used as a selection criterion to differentiate ankle-foot units for prosthetic users and their bandwidth of walking speeds.Prosthetic push-off power in trans-tibial amputee walking PLOS ONE | https://doi.org/10.

Introduction:Neuroprostheses that can relay signals to and from the nervous system and work with lower-limb prostheses are currently being developed to provide users with sensory feedback and/or intent control over their prostheses. Such systems incorporate functions not available to persons with lower-limb amputation before, and many of their potential benefits have not yet been addressed in performance-based outcome measures. As such, the evaluation of neuroprosthetic systems is considerably more difficult than that of current devices, which are already difficult due to limitations of testing strategies. This review includes an overview of performance-based measures for lower-limb prostheses as well as an appraisal of their utility for neuroprosthetic assessment. Methods: Electronic searches were conducted (2013)(2014)(2015)(2016)(2017)(2018)(2019) in the PubMed (PM) database, the Web of Science (WOS), and Cochrane (CC), resulting in 72 included articles. Conclusions: There is an urgent need for further development of performance tests and metrics, as well as new strategies specifically intended for the evaluation of lower-limb neuroprosthetic systems. (