Assessment of low- and high-level task performance in people with transtibial amputation using crossover and energy-storing prosthetic feet: A pilot study.

Abstract

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. 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. Cross-sectional, repeated measures. 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. 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). 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. 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.