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A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
Assessment of low- and high-level task performance in people with transtibial amputation using crossover and
Elizabeth G Halsne1, Cody L McDonald1, Sara J Morgan1
1Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
Background::
Crossover feet incorporate features of energy-storing feet and running-specific feet. As such, crossover feet may be suitable for both daily ambulation and participation in physically demanding activities.
Objectives::
To compare crossover feet and energy-storing feet on performance-based tests including a range of low-level (e.g. sit-to-stand) and high-level (e.g. jogging) activities.
Study Design::
Cross-sectional, repeated measures.
Methods::
Participants with transtibial amputation completed a battery of performance-based outcome measures, including the Five Times Sit-to-Stand, Timed-Up-and-Go, Four Square Step Test, and the Comprehensive High-level Activity Mobility Predictor. Participants wore duplicate prostheses fit with crossover feet and energy-storing feet to perform the tests; the order of foot conditions was randomized. Paired t tests were used to evaluate differences between feet and order of testing.
Results::
Data from seven participants showed improvements in all measures while using crossover feet. Improvements in the second foot condition were also observed, indicating a practice effect for all measures. However, differences between feet and order of conditions were not statistically significant ( p > 0.05).
Conclusion::
Results of this study suggest that crossover feet may improve low- and high-level mobility outcomes. However, intervention effects are small and practice effects were observed in all outcomes. Future research is needed to evaluate the influence of practice effects on performance-based mobility measures.
Clinical Relevance:
Crossover feet may improve transtibial prosthesis users' performance compared to energy-storing feet across a range of activities, but additional research is needed. Practice effects may be an influential factor in the measurement of performance-based mobility outcomes and should be considered when performing a clinical assessment.
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