Influence of prosthetic foot selection on walking performance during various load carriage conditions

Ambulatory individuals with lower limb amputations often face challenges with body support, body propulsion, and balance control. Carrying an infant, toddler, backpack, or other load can exacerbate these challenges and highlights the importance of prescribing the most suitable prosthetic foot. The aim of this study was to examine the influence of five different prosthetic feet on walking performance during various load carriage conditions.

Biomechanical data were collected from twelve participants wearing five different prosthetic feet (four passive, one powered) while walking with no added load and carrying a load of 13.6 kg in four different positions: posterior, anterior, prosthetic side, and intact side.

Based on our study population, a powered-ankle-foot offers additional body support when a load is carried posteriorly. If additional forward propulsion is needed while carrying a load anteriorly, a heel wedge is better than a stiffer foot. For individuals who may need additional sagittal plane balance control, no study foot was advantageous regardless of how the load was carried. For those who need additional frontal plane balance control during posterior load carriage, a heel wedge is better than a stiffer or powered foot. Lastly, the standard-of-care, heel wedge, and dual keel feet provided more frontal plane balance control than a powered foot when a load was carried anteriorly.

For individuals with lower limb amputation who carry loads, consideration of their preferred load carrying method may help select an appropriate prosthetic foot for body support, propulsion, and balance control.