Driving Pedal Reaction Times After Right Transtibial Amputations

Abstract

Meikle B, Devlin M, Pauley T. Driving pedal reaction times after right transtibial amputations. Objectives To determine if right transtibial amputees have the potential to safely operate the foot pedals of a vehicle with their prosthetic foot, and to determine which of 4 driving techniques is associated with the fastest reaction times. Design Repeated measures. Setting Outpatient amputee clinic. Participants Ten subjects with right-sided, transtibial amputations. Intervention Brake pedal response times were measured using 4 different driving techniques: right-sided accelerator with (1) prosthesis operating both the accelerator and brake pedals, (2) prosthesis operating the accelerator and left foot operating the brake, (3) left foot operating both the accelerator and brake, and (4) left-sided accelerator with the left foot operating both the accelerator and brake. Main Outcome Measures Reaction time, movement time, total response time, and pedal configuration preference. Results Total response times were slowest using a 2-footed driving technique ( P<.001). Total response times were comparable using a left-sided accelerator versus the prosthesis. Using the left foot to operate both the accelerator and brake in a conventional right-footed accelerator design led to the fastest reaction ( P<.001) and total response times ( P<.01), although it is unclear if this is a realistic driving technique for all amputees. Conclusions Our results suggest that right transtibial amputees should be instructed not to drive with a 2-footed technique, and that they have similar pedal response times using their prosthesis when compared with a left-sided accelerator.