powered ankle prosthesis on slopes

quick release handcycle grip

class: Clincal Gait Analyis
term: fall 2024
write up: PDF

Background: Sloped walking is of particular difficulty for people with transtibial amputations. This can in part be attributed to their lack of plantar flexor power during push-off and lack of dorsiflexion to allow for toe clearance during swing (especially on inclines). Powered ankle-foot prostheses (PAFP) have been introduced as a possible solution to these issues. While these devices are designed to provide the kind of assistance that those with transtibial amputations seem to need at the ankle, it is unclear how beneficial these devices are when evaluated more wholistically.

Methods: A systemic literature review was performed using PUBMED, SCOPUS, WEB OF SCIENCE, IEEE Xplore, MEDLINE, EMBASE, and MANUAL SEARCH in September and October of 2024. The focus of our search was on people with unilateral transtibial amputations using a PAFP to walk on sloped surfaces. Outcome measures were narrowed down for commonality across the different papers following full text evaluation.

Results: This literature review garnered seven papers. Across these seven papers, four found reductions in metabolic expenditure in those using a PAFP, three found reductions in compensatory hip and knee kinetics of the contralateral leg, and four found improved ankle kinetics.

Significance: Given the small body of work that exists, it is difficult to make a wholistic assessment on PAFPs for use in sloped walking. The currently published works on the topic indicate multiple benefits, especially to those with pronounced compensatory hip and knee joint strategies. More work should be done to evaluate PAFPs for sloped walking using a wholistic slate of outcome measures such as balance metrics and temporal spacial parameters. There is also a need for work evaluating long term benefits or lack-there-off of PAFPs after ambulatory strategies have had time to full adjust to the device.