Prosthetic Feet

Design Criteria:
Prosthetic Feet
During gait cycle human foot offers:

Adaptations to uneven surfaces

Shock absorption at initial contact
Torque conversion
Knee stabilization
Transfer of body weight forces
Limb lengthens/shortens even the arc C.O.G.in forward
progression
Stable weight bearing base

Early Stance - End of Stance

Early stance
Human foot is flexible, it accommodates to
uneven terrain, maintains balance
End of stance

Human foot converts to rigid lever arm for

push off at preswing

Design? How well do

Prosthetic Feet address Stance
Shock absorption & controlling planterflexion
in loading response
Accommodation to uneven terrain &
controlled advancement of prosthetic
shank/shin during midstance
Heel rise & weight transfer during terminal
stance
Transition through double support &
preparation for swing phase

Initial Contact Into Loading Response

Two functional tasks in early stance:
1) Shock absorption-knee flexion moment
2) Transition to foot flat position:
G.R.F. is posterior to ankle creates a
planterflexion moment drives foot to
floor

Midstance
Momentum of swing limb & forward fall of
body weight create a dorsiflexion torque that
moves the tibia over the weight bearing foot
8 planterflexion 5 dorsiflexion
Eccentric contraction gastrocnemius/soleus
controls speed, maintain stance stability

Prosthetic foot simulates this muscle

activity, stance phase stability through
rigid/semirigid or flexible keel foot

Terminal Stance
Anatomic foot-ankle complex locks into position,
provides for heel rise, tibia continues to advance
forward
Body weight is transferred forward onto forefoot
as it rolls over mp joints
This allows foot to roll over at metatarsal heads,
instead of the tips of your toes
Prosthetic foot must provide terminal stance phase
support and simulate mp dorsiflexion, which is
necessary for toe rocker

Preswing
Dual limb support - weight of body is transferred
from preswing limb to contralateral side
Muscle force of gastroc/soleus , ankle begins to
planterflex
Prosthetic foot provides sufficient support on
amputated side/assist balance/facilitate smooth
transfer of weight to sound side.
force placed on sound side foot, especially pts
with compromised vascular and neurologic systems

Categories of Prosthetic Feet

Non articulating: SACH (solid ankle cushioned heel)
Articulating: single-axis or multiaxial
Elastic keel: SAFE (solid ankle flexible exoskeleton)
STEN (STored ENergy)
Dynamic response: Seattle, Flex foot, Springlite, Pathfinder

SACH:Solid Ankle Cushioned Heel

Single Axis / Exoskeletal

Single Axis / Endoskeletal

Articulating:
Multiaxial/Exoskeletal

Aticulating:
Multiaxial/Endoskeletal

Elastic Keel: SAFE Foot, STEN Foot

Dynamic Response:
Ossur Ceterus, Endolite Elite

Dynamic Response:
Ossur Flex foot

Dynamic Response:
OWW Pathfinder

Dynamic Response:
College Park - VENTURE

Proper Heel Height

Choosing Appropriate Foot

Heel height / standard prosthetic foot heel / athletic 3/8 western
boot 2
Ability to resist moisture
Cosmetic appearance-toes, veins, medial/lateral malleoli
Prosthetic users activity level: Medicare K level 0- 4

Choosing An Appropriate Foot

Ability or potential to reach a higher level
Vocational / recreational
Maintenance / distance to prosthetist
Team effort / clinic team!

Cosmetic Skin

Evolution of Cosmetics

Medicare K Levels:
Set on Ability or Potential
K0 To ambulate or transfer safely with or without
assistance and a prosthesis does not enhance quality of
life or mobility
K1 To use a prosthesis for transfers, or for ambulation on
level surfaces at a fixed cadence - household ambulator
K2 Transverse low level barriers-curbs, stairs or uneven
surfaces-limited community ambulator
K3 Variable cadence beyond simple walking

K4 ambulatory skills - high impact, children active adults,

& athletes