Abstract
The development and prescription of energy storage and return prosthetic feet in favor
of conventional feet is largely based upon prosthetist and amputee experience. Regretfully,
the comparative biomechanical analysis of energy storage and return and conventional
prosthetic feet is rarely a motivation to either the technical development or clinical
prescription of such devices. The development and prescription of prosthetic feet
without supportive scientific evidence is likely due to the conflicting or non-significant
results often presented in the scientific literature. Despite the sizeable history
of comparative prosthetic literature and continued analysis of prosthetic components,
the link between clinical experience and scientific evidence remains largely unexplored.
A review of the comparative analysis literature evaluating energy storage and return
and conventional prosthetic feet is presented to illustrate consistencies between
the perceptive assessments and the objective biomechanical data. Results suggest that
while experimental methodologies may limit the statistical significance of objective
gait analysis results, consistent trends in temporal, kinetic, and kinematic parameters
correlate well with perceptive impressions of these feet. These correlations provide
insight to subtle changes in gait parameters that are deemed neither clinically nor
statistically significant, yet are perceived by amputees to affect their preference
for and performance of prosthetic feet during locomotion.
Acknowledging and targeting areas of perceptive significance will help researchers
develop more structured protocols for energy storage and return prosthesis evaluation
as well as provide clinicians with information needed to enhance the appropriateness
of their clinical recommendations. Expanding test environments to measure activities
of perceived improvement such as high-velocity motions, stair ascent/descent, and
uneven ground locomotion will provide a more appropriate assessment of the conditions
for which energy storage and return prosthetic feet were designed. Concentrating research
to specific test populations by age or amputation etiologies can overcome statistical
limitations imposed by small study samples. Finally, directing research toward the
areas of gait adaptation, heel performance, and the temporal release of energy in
energy storage and return feet may reinforce the selection and utilization of advanced
prosthetic components. These enhancements to current biomechanical analyses may serve
to reduce the boundaries of perceptive significance and provide clinicians, designers,
and researchers with the supportive data needed to prescribe, design, and evaluate
energy storage and return prosthetic feet.
Keywords
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Article info
Publication history
Accepted:
March 11,
2002
Received:
March 6,
2002
Identification
Copyright
© 2002 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
