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Matthew J. Major, PhD; Laurence P. J. Kenney, PhD; Martin Twiste, PhD; David Howard, PhD

Stance phase mechanical characterization of transtibial prostheses distal to the socket: A review. Matthew J. Major, PhD; Laurence P. J. Kenney, PhD; Martin Twiste, PhD; David Howard, PhD. Aim

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Matthew J. Major, PhD; Laurence P. J. Kenney, PhD; Martin Twiste, PhD; David Howard, PhD

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  1. Stance phase mechanical characterization of transtibial prostheses distal to the socket: A review Matthew J. Major, PhD; Laurence P. J. Kenney, PhD; Martin Twiste, PhD; David Howard, PhD

  2. Aim • Introduce framework for studying prosthesis design, including Amputee Independent Prosthesis Property (AIPP) characterization, human performance/gait simulation studies, and detailed design. • Relevance • Most studies on effects of prosthesis design on amputee performance compare different products’ biomechanical and physiological effects, without characterizing AIPPs. • This approach only indicates relative performance, but cannot explain why one prosthesis performs better than another.

  3. Framework for studying prosthesis design.

  4. Methods • Literature search • Primary: MEDLINE/EMBASE, 1970 to July 2011. • Secondary: Using references in primary search to include journals not indexed in MEDLINE/EMBASE. • Exclusion criteria: • Only reported fatigue testing of components. • Tested prostheses with socket and shank constructed of single material. • Tested prostheses capable of internal power-generation. • Tested components from transfemoral amputee gait studies. • Written in language other than English.

  5. Results • Primary search: • 443 MEDLINE articles, 410 EMBASE articles. • 36 satisfied criteria. • 5 relevant review papers identified. • Sagittal plane behavior of passive transtibial prosthesis during gait can be described by following AIPPs: • Two-dimensional roll-over shape,alignment of roll-over shape, elastic properties, damping properties, and mass properties.

  6. Conclusion • Proper AIPP characterization essential to research stage of design approach. • Properties of existing prostheses should be measured independent of amputee (AIPPs) before in vivo performance testing. • Better understanding of correlations between AIPPs and their effects on gait can be developed through studies measuring both AIPPs and gait performance, with amputees grouped by motor capacity. • Desirable AIPPs could then become inputs to prosthesis design process.

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