Effects of an active prosthetic ankle during ambulation on stairs and ramps
© Alimusaj et al; licensee BioMed Central Ltd. 2008
Published: 26 September 2008
Conventional prosthetic ankle foot systems are commonly not able to adapt to different conditions, e.g. stairs and ramps. Walking on inclined surfaces or stairs is therefore a particular challenge for a prosthetic user . So the amputee is forced to compensate the deficits of his prosthesis by adapting the kinematics and kinetics of the proximal and the contra lateral joints .
The Proprio-Foot™ (Ossur) shall be able to reduce these compensating mechanisms as a result of an adaptive microprocessor controlled ankle .
Twenty non vascular transtibial amputees (49 ± 12 years) underwent a conventional 3D gait analysis (VICON & Kistler) . Kinematics and kinetics of the lower limbs were analyzed during ambulation on an instrumented stair with five steps and an instrumented ramp with an incline of 7.5°. The condition of the adapted ankle was compared to the non-adapted ankle.
Average data (mean± std) of knee extension and knee extensor moments during ambulation on the stair and the ramp for N = 10
Knee extension [deg]
0.2 ± 7.9 *
-10.7 ± 4.9 *
-14.2 ± 5.4 **
-13.0 ± 3.2 *
2.9 ± 9.7 *
-7.5 ± 5.9 *
-18.2 ± 4.1 **
-13.7 ± 4.1 *
(p < 0.05)
(p < 0.05)
(p < 0.002)
(p = 0.358)
Knee extending moments [Nm/kg]
0.3 ± 0.2 *
0.0 ± 0.2 *
0.6 ± 4.2 *
-0.2 ± 0.1 *
0.4 ± 0.2 *
0.1 ± 0.2 *
0.8 ± 2.2 *
-0.2 ± 0.2 *
(p < 0.002)
(p = 0.194)
(p < 0.02)
(p = 0.158)
Preliminary data of ten participants show significant changes in kinematics and kinetics for the knee in the involved side during ambulation with the adapted compared to the non-adapted prosthetic ankle foot system.
Particularly during ramp and stair ascend, the adaptation leads to a significantly reduced knee extension (p < 0.05) and to significantly reduced knee extensor moments in the prosthetic side (p < 0.02).
Similar results could be partially found for the knee kinematics when descending the stair (p < 0.05). Although patients reported a broad benefit during ramp descend, only a small but not significant difference for the maximum knee extension could be found in the involved side (p = 0.358).
The preliminary findings suggest that the prosthetic ankle adaptation leads to more physiological knee kinematics and kinetics in the involved limb during walking on stairs and ramps.
For a final conclusion, complete results of twenty patients in the involved and the contra lateral sides and normal reference data have to be taken into account.
The authors would like to thank all the participants for their attendance. The financial support of Ossur Europe is gratefully acknowledged as well.
- Vickers DR, et al: Gait & Posture. 2008, 27 (3): 518-529. 10.1016/j.gaitpost.2007.06.008.View ArticleGoogle Scholar
- Nolan L, et al: Prosthet Orthot Int. 2000, 24 (2): 117-125. 10.1080/03093640008726534.View ArticlePubMedGoogle Scholar
- Braatz F, et al: Orth Tech. 2006, 8: 608-611.Google Scholar
- Kadaba MP, et al: J Orthop Res. 1989, 7 (6): 849-860. 10.1002/jor.1100070611.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd.