The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system

Major, Matthew J.; Scham, Joel; Orendurff, Michael S.

doi:10.1177/0309364617706749

Cited by 35 publications

(69 citation statements)

References 36 publications

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“…For example, carbon fiber reinforced polymers now incorporated in many energy storage-and-return (ESAR) and dynamic prosthetic feet (e.g., Flex-Foot series, Össur), can demonstrate decreased net energy loss relative to other feet constructed of conventional composites and polymers (e.g., Solid Ankle Cushion Heel (SACH) series, Otto Bock, or Seattle Lightfoot, Seattle Systems, USA) 35–39 . The hypothesis was that modifications in mechanical function would be reflected in user performance 18, 20 , such as reduced metabolic cost of gait 35, 36 .…”

Section: Optimizing Passive Prosthesis Design Through Parametric Smentioning

confidence: 99%

“…For example, footwear may substantially affect regional and overall stiffness and damping of prosthetic feet, in some instances normalizing the mechanical function across designs 35, 37, 39, 70 . Additionally, the choice of suspension system and constituent components 71 will play a role in determining the residuum-prosthesis interface properties and behavior 72, 73 , and this is especially relevant with the advent of bone-anchored prostheses (osseointegration) 74 .…”

Section: Optimizing Passive Prosthesis Design Through Parametric Smentioning

confidence: 99%

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Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes

Major

Fey

2017

Physical Therapy Reviews

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Background Selection of prosthesis mechanical characteristics to restore function of persons with lower-limb loss can be framed as an optimization problem to satisfy a given performance objective. However, the choice of a particular objective is critical, and considering only device and generalizable outcomes across users without accounting for inherent motor performance likely restricts a given patient from fully realizing the benefits of a prosthetic intervention. Objectives This review presents methods for optimizing passive below-knee prosthesis designs to maximize rehabilitation outcomes and how considerations on patient motor performance may enhance these outcomes. Major Findings Available literature supports that considering patient-specific variables pertaining to motor performance permits a multidimensional landscape relating device characteristics and user function, which may yield more accurate predictions of rehabilitation outcomes for individual patients. Moreover, the addition of targeted physical therapeutic interventions that encourage user self-organization may further improve these outcomes. We note the potential of existing paradigms to address these additional dimensions, and we encourage investigators to consider the many different performance objectives available for prosthesis optimization. Conclusions By considering user motor performance in combination with prosthesis mechanical characteristics, a staged optimization approach can be formulated which acknowledges that device modifications may only improve outcomes to a certain extent and user self-organization is a critical component to complete rehabilitation. An iterative process that can be integrated within existing rehabilitative practices accounts for changes in patient status through combined targeted prosthetic solutions and physical therapeutic techniques, and embodies the concept of personalized intervention for patients with lower limb-loss.

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Section: Optimizing Passive Prosthesis Design Through Parametric Smentioning

confidence: 99%

Section: Optimizing Passive Prosthesis Design Through Parametric Smentioning

confidence: 99%

Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes

Major

Fey

2017

Physical Therapy Reviews

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“…It is unknown how changes to alignment affect preferred stiffness; this is a potential avenue for future study. Similarly, we elected not to use a shoe on the prosthetic foot to facilitate complete control of stiffness adjustments, but shoes can add substantial series compliance [ 15 ], which would likely affect both preferred stiffness and JND. Stiffness preference was assessed at a steady speed on a treadmill, and may differ during over-ground walking with frequent stops.…”

Section: Discussionmentioning

confidence: 99%

“…The ankle could be commanded to change stiffness by either the experimenter, who could communicate with the onboard computer ( Raspberry Pi Zero , Raspberry Pi Foundation, Cambridgeshire UK) over WiFi, or directly by the subject, using a small dial which could rotate indefinitely and had no absolute reference. The ankle was worn without a shoe to avoid additional compliance and confounding factors [ 15 ]. Instead, a 6 mm piece of shoe material ( SolFlex crepe , Shore A durometer 50–55, SoleTech, Nahant, MA, US) was epoxied to the bottom of the foot to aid in shock absorption, and a thin tread ( Diamond , durometer 50–55, SoleTech) was epoxied below that shoe material for traction.…”

Section: Methodsmentioning

confidence: 99%

Amputee perception of prosthetic ankle stiffness during locomotion

Shepherd

Azocar

Major

et al. 2018

J NeuroEngineering Rehabil

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BackgroundProsthetic feet are spring-like, and their stiffness critically affects the wearer’s stability, comfort, and energetic cost of walking. Despite the importance of stiffness in ambulation, the prescription process often entails testing a limited number of prostheses, which may result in patients receiving a foot with suboptimal mechanics. To understand the resolution with which prostheses should be individually optimized, we sought to characterize below-knee prosthesis users’ psychophysical sensitivity to prosthesis stiffness.MethodsWe used a novel variable-stiffness ankle prosthesis to measure the repeatability of user-selected preferred stiffness, and implemented a psychophysical experiment to characterize the just noticeable difference of stiffness during locomotion.ResultsAll eight subjects with below-knee amputation exhibited high repeatability in selecting their Preferred Stiffness (mean coefficient of variation: 14.2 ± 1.7%) and were able to correctly identify a 7.7 ± 1.3% change in ankle stiffness (with 75% accuracy).ConclusionsThis high sensitivity suggests prosthetic foot stiffness should be tuned with a high degree of precision on an individual basis. These results also highlight the need for a pairing of new robotic prescription tools and mechanical characterizations of prosthetic feet.

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“…During the data collection, no shoes or footwear were used to avoid their influence on the participant’s gait. 13 Furthermore, having the participants walk without footwear mimicked their daily life of walking without shoes in their home.…”

Section: Methodsmentioning

confidence: 99%

The effect of coronal prosthetic alignment changes on socket reaction moments, spatiotemporal parameters, and perception of alignment during gait in individuals with transtibial amputation

Hashimoto

Kobayashi

Gao

et al. 2018

Journal of Rehabilitation and Assistive Technologies Engineerin

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Introduction The alignment of a prosthesis is clinically determined based on observations by clinicians and the subjective perception of amputees during gait. However, this process has been reported to be unreliable. Socket reaction moment has been reported to be significantly impacted by alignment changes, but the impact of these alignment changes on other gait parameters is unclear. The aim of this study was to investigate the effects of coronal alignment changes of a transtibial prosthesis on socket reaction moment, spatiotemporal parameters, and perceptions of alignment during gait in amputees. Methods Nine individuals with transtibial amputation participated in this study. Socket reaction moment and spatiotemporal parameters (step time, step length, step width, single limb support time, cadence, and gait speed) were measured under nine coronal alignment conditions (angulation: ±3°, ±6°, translation: ±5 mm, ±10 mm, and baseline) using a three-dimensional motion capture system (Vicon) and an embedded load-cell system (Europa™). In addition, subjective perceptions of alignment were examined. Results Coronal alignment changes of the transtibial prostheses demonstrated significant changes in socket reaction moment; however, no significant changes were found with spatiotemporal parameters or the amputee’s perception. Conclusion Measurement of socket reaction moment, along with the embedded load-cell system, may be a better metric for tuning the coronal alignment of transtibial prostheses compared to spatiotemporal parameters and amputee’s perceptions.

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The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system

Cited by 35 publications

References 36 publications

Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes

Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes

Amputee perception of prosthetic ankle stiffness during locomotion

The effect of coronal prosthetic alignment changes on socket reaction moments, spatiotemporal parameters, and perception of alignment during gait in individuals with transtibial amputation

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