Major Matthew J, Scham Joel, Orendurff Michael
1 Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
2 Department of Veterans Affairs, Jesse Brown VA Medical Center, Chicago, IL, USA.
Prosthet Orthot Int. 2018 Apr;42(2):198-207. doi: 10.1177/0309364617706749. Epub 2017 May 9.
Prosthetic feet are prescribed based on their mechanical function and user functional level. Subtle changes to the stiffness and hysteresis of heel, midfoot, and forefoot regions can influence the dynamics and economy of gait in prosthesis users. However, the user's choice of shoes may alter the prosthetic foot-shoe system mechanical characteristics, compromising carefully prescribed and rigorously engineered performance of feet.
Observe the effects of footwear on the mechanical properties of the prosthetic foot-shoe system including commonly prescribed prosthetic feet.
Repeated-measures, Mechanical characterization.
The stiffness and energy return was measured using a hydraulic-driven materials test machine across combinations of five prosthetic feet and four common shoes as well as a barefoot condition.
Heel energy return decreased by an average 4%-9% across feet in all shoes compared to barefoot, with a cushioned trainer displaying the greatest effect. Foot designs that may improve perceived stability by providing low heel stiffness and rapid foot-flat were compromised by the addition of shoes.
Shoes altered prosthesis mechanical characteristics in the sagittal and frontal planes, suggesting that shoe type should be controlled or reported in research comparing prostheses. Understanding of how different shoes could alter certain gait-related characteristics of prostheses may aid decisions on footwear made by clinicians and prosthesis users. Clinical relevance Shoes can alter function of the prosthetic foot-shoe system in unexpected and sometimes undesirable ways, often causing similar behavior across setups despite differences in foot design, and prescribing clinicians should carefully consider these effects on prosthesis performance.
假肢脚是根据其机械功能和使用者的功能水平来开具处方的。足跟、中足和前足区域的刚度和滞后性的细微变化会影响假肢使用者的步态动力学和经济性。然而，使用者选择的鞋子可能会改变假肢脚-鞋系统的机械特性，从而损害精心开具处方和严格设计的假肢性能。
观察鞋类对假肢脚-鞋系统（包括常用的假肢脚）机械性能的影响。
重复测量、机械特性分析。
使用液压驱动的材料试验机，对五种假肢脚和四种常见鞋子的组合以及赤脚状态下的刚度和能量回返进行测量。
与赤脚相比，所有鞋子中各假肢脚的足跟能量回返平均降低了4%-9%，其中减震训练鞋的影响最大。通过提供低足跟刚度和快速平足来改善感知稳定性的足部设计，会因添加鞋子而受到影响。
鞋子改变了假肢在矢状面和额状面的机械特性，这表明在比较假肢的研究中应控制或报告鞋类类型。了解不同鞋子如何改变假肢的某些与步态相关的特性，可能有助于临床医生和假肢使用者做出关于鞋类的决策。临床相关性：鞋子会以意想不到且有时不理想的方式改变假肢脚-鞋系统的功能，尽管足部设计不同，但通常会在不同设置中导致类似的情况，开具处方的临床医生应仔细考虑这些对假肢性能的影响。
