title: Comparison between microprocessor-controlled ankle/foot and conventional prosthetic feet during stair negotiation in people with unilateral transtibial amputation.
abstract: Contrary to stance-phase dorsiflexion of conventional prosthetic feet, the microprocessor-controlled Proprio foot permits swing-phase dorsiflexion on stairs. The purpose of this study was to compare Symmetry in External Work (SEW) between a microprocessor-controlled foot and conventional prosthetic feet in two groups with unilateral transtibial amputation (Medicare Functional Classification Levels K-Level-2 and K-Level-3) during stair ascent and descent. Ten subjects were evaluated while wearing three conventional prosthetic feet- solid ankle cushion heel (SACH), stationary attachment flexible endoskeleton (SAFE), and Talux-and the Proprio foot using a study socket and were given a 10- to 14-day accommodation period with each foot. Ground reaction forces were collected using F-scan sensors during stair ascent and descent. The SEW between the intact and amputated limbs was calculated for each foot. During stair ascent, the Proprio foot resulted in a higher interlimb symmetry than conventional prosthetic feet, with significant differences between the Pro prio and SACH/SAFE feet. The swing-phase dorsiflexion appeared to promote greater interlimb symmetry because it facilitated forward motion of the body, resulting in a heel-to-toe center of pressure trajectory. During stair descent, all feet had low symmetry without significant differences between feet. The movement strategy used when descending stairs, which is to roll over the edge of a step, had a greater influence on symmetry than the dorsiflexion features of prosthetic feet.
authors.affiliation: Department of Physical Therapy, Miller School of Medicine, University of Miami, 5915 Ponce de Leon Blvd, Plummer Building 5th floor, Coral Gables, FL 33146. vibhor@umail.miami.edu.
authors.forename: Vibhor
authors.initials: V
authors.lastname: Agrawal
authors.forename: Robert S
authors.initials: RS
authors.lastname: Gailey
authors.forename: Ignacio A
authors.initials: IA
authors.lastname: Gaunaurd
authors.forename: Christopher
authors.initials: C
authors.lastname: O'Toole
authors.forename: Adam A
authors.initials: AA
authors.lastname: Finnieston
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000673:Amputation, Traumatic / Q000503:physiopathology / Q000534:rehabilitation*; D000843:Ankle Joint; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D005260:Female; D005528:Foot; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008838:Microcomputers; D008875:Middle Aged; D011474:Prosthesis Design; D013977:Tibia / Q000293:injuries / Q000601:surgery
keywords: Proprio foot; Symmetry in 
  External Work; center of pressure; external work; foot dorsiflexion; microprocessor-controlled foot; prosthetic feet 
  comparison; stair ascent; stair descent; symmetry