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Interfacial pressures at the human-machine interface can be a source of discomfort and potentially devastating tissue damage. These stresses may be reduced through a thorough understanding of the relevant biomechanics and interface design.

Effects of a powered ankle-foot prosthesis on kinetic loading of the contralateral limb: A case series

Lower extremity amputees encounter a series of stress related challenges. Among them is an increased risk of chronic joint disorders. For unilateral, transtibial amputees, we hypothesize that increasing the power output of the trailing, ankle-foot prosthesis during powered plantar flexion could mitigate kinetic loading applied to the leading, contralateral leg during walking. Here, we present a case series that analyzes kinetic factors of unilateral, transtibial amputee gait and forms a comparison between two types of ankle prostheses with varying power outputs. The factors examined here are impact resultant force, peak foot pressure at heel-strike, step to step transition work, and knee external adduction moment. The two prostheses are the amputee participant’s daily use passive ankle-foot prosthesis and the BiOM powered ankle-foot prosthesis
capable of biologically accurate powered plantar flexion during late stance. In a preliminary study on two transtibial amputees walking over level terrain at a controlled speed (1.25 m/s), we observed average reductions of 8% in peak impact resultant force, 18% in impact resultant force loading rate, 8% in peak heel-strike foot pressure, and 15% in the 1st peak knee external adduction moment when the powered ankle-foot prosthesis was compared to the conventional passive prosthesis. Overall, our preliminary results suggest that more biomimetic prosthetic ankle-foot push off during late stance may limit leading leg musculoskeletal stress in walking.