This article and any supplementary material should be cited as follows: Johnson L, De Asha AR,...

This article and any supplementary material should be cited as follows: Johnson L, De Asha AR, Munjal R, Kulkarni J, Buckley JG. Toe clearance when walking in people with unilateral transtibial amputation: Effects of passive hydraulic ankle. J Rehabil Res Dev. 2014;51(3):xx–xx.http://dx.doi.org/10.1682/JRRD.2013.05.0126

Slideshow ProjectDOI:10.1682/JRRD.2013.05.0126JSP

Toe clearance when walking in people with unilateral transtibial amputation:

Effects of passive hydraulic ankle

Louise Johnson, PhD; Alan R. De Asha, MSc; Ramesh Munjal, FRCS; Jai Kulkarni, FRCS; John G. Buckley, PhD



• Aim– Investigate if using prosthetic foot with hydraulically

controlled articulating ankle that allows foot to be relatively dorsiflexed at toe-off and throughout swing increases minimum toe clearance (MTC).

• Relevance– Most clinically available prosthetic feet have rigid

attachment or incorporate “ankle” device allowing elastic articulation during stance, with foot returning to “neutral” position at toe-off.



Method

• 21 people with unilateral transtibial amputation completed overground walking trials using their habitual prosthetic foot with rigid or elastic articulating attachment and a foot with a hydraulic ankle attachment (hyA-F).

• MTC and other kinematic variables were assessed across multiple trials.



Results• When using hyA-F:– Mean MTC increased on both limbs. • On prosthetic limb, this was partly due to device being in its

fully dorsiflexed position at toe-off, which reduced the “toes down” foot angle throughout swing.

– Walking speed increased and was associated with greater swing-limb hip flexion on prosthetic side, which may have contributed to increased mean MTC.

– Variability in MTC increased on prosthetic side, but did not increase risk of tripping.



Conclusion

• Using hyA-F could increase MTC and walking speed in persons with amputation.

This article and any supplementary material should be cited as follows: Johnson L, De Asha AR,...

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