Types of prosthetic feet

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Background

The human gait is an artform of controlled falling. One requirement of normal gait is the ability to adapt it to a wide-ranging set of environments (Shumway-Cook & Woollacott, 2007b). Walking is an energy demanding task due to the movement off the body in three planes; sagittal, frontal and transversal. (Figure 1). The most noticeable movement during gait is in the sagittal plane. Because humans depend on bipedal motion there will always be some form of frontal plane movement and height change of centre of gravity (COG) as well (Perry & Burnfield, 2010). The COG does not stay within the support base of the feet, and thus the body is in a continuous state of imbalance. The only way to prevent falling is to place the swinging foot ahead of and lateral to the centre of gravity as it moves forward, thus ensuring control of the centre of mass (COM) relative to a moving Base of support (BoS) (Shumway-Cook & Woollacott, 2007a).
Most researches focus on motion in just one of these planes, sagittal. Even during straight line walking there is always some frontal plane motion as well sagittal (Evandro M. Ficanha, 2015). Therefore, there is a lack of understanding of what happens in the frontal plane during gait. As we walk there is a weight shift between feet. A foot needs to be able to function in other motions than straight line walking, e.g. turning, adapting to uneven terrain, ascending or descending slopes (Evandro Maicon Ficanha, Ribeiro, Dallali, & Rastgaar, 2016).
The anatomical ankle foot complex (AFC) needs to act as a dampener, support and rigid lever at different stages of the gait cycle. The foot consists of 28 bones and 25 joints. To ease for understanding of the different segments the AFC is commonly divided up in three segments, hindfoot, midfoot and forefoot (Mueller, 2005), see Figure 2. There are three motional pairs in the ankle foot complex which roughly follow the cardinal planes of motion. These are dorsiflexion/plantarflexion, inversion/eversion, abduction/adduction. Dorsiflexion/plantarflexion is the motion in sagittal plane, abduction/adduction is in transversal plane. Inversion/eversion follows the frontal plane. Eversion is when the plantar surface is brought away from the midline, inversion is the opposite. The terms pronation/supination is a term used to describe coupled movements of the terms above, e.g. pronation includes dorsiflexion, eversion and abduction were as supination is the opposite (Mueller, 2005).

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Aims

The aim of the study to investigate if the VSc system is capable of measuring torsional moments in frontal plane during straight line walk in two different types of prosthetic feet. The following research questions were asked:
H0: There is no statistical significant difference between individually measured frontal plane moment in measuring sensor (one, two, three, four or five) in two different types of prosthetic feet, when the user walks in a straight line.
H1: There is a statistical significant difference between individually measured frontal plane moments in measuring sensor (one, two, three, four or five) in two different types of prosthetic feet, when the user walks in a straight line.

Method

Participants

Participation inclusion criteria was being a unilateral transtibial (TT) amputee, with at least two years as active prosthetic users. They had to be of working age, between 18 and 67, and be active walkers. Exclusion criteria was having diabetes and/or any neurological disease, inability to walk 100+ meters at once. CPO’s were asked to contact their patients that met the research criteria and ask if they were interested in participating. If they showed interest, an informational flier was sent to them via mail or e-mail with further information about the study and the researchers contact information. Participants were of similar height, weight, and wore the same type of shoe. Table 1 displays demographic data of the participants. Informed consent form and information flier can be seen in appendix one.

Abstract
1 Introduction
2 Background
3 Aims
4 Method
4.1 Participants
4.2 Equipment
4.3 Data collection
4.4 Data analysis and statistics
4.5 Ethical considerations
5 Results
5.1 Participants
5.2 Description of results
6 Discussion
6.1 Comparison with a 3D analysis system
6.2 Limitations
6.3 Future researches
7 Conclusion
References
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