Effects of Hydraulic Ankle-Foot Prostheses on Gait in Individuals with Transtibial Limb Loss: A Scoping Review

Abstract

ABSTRACT Introduction The purpose of this scoping review was to determine if sufficient evidence exists to conduct a formal systematic review or meta-analysis of hydraulic ankle-foot (HAF) prostheses and to determine if evidence statements could be synthesized relative to the effects of HAF prostheses on gait in individuals with transtibial limb loss. Methods Electronic database searches were conducted in MEDLINE, Embase, Web of Science, Scopus, and Proquest covering 1788 to 2017. Two reviewers independently completed screening and data extraction. Results The scoping review resulted in 15 articles that satisfied the inclusion/exclusion criteria. The majority of studies were completed in the United Kingdom and consisted of prospective protocols performed in research laboratories. All studies used the same HAF prosthesis intervention. The intervention studies reported a variety of biomechanical and patient-reported outcome measures. Conclusions Results of the scoping review indicate that there is a need to evaluate the quality of the HAF prosthetic literature with a systematic review or meta-analysis. Clinical Relevance There has been an increase in the number of commercially available passive hydraulic ankle-foot prostheses. This study provides an overview of evidence related to the effects of these HAF prostheses on transtibial prosthesis users' gait biomechanics and patient-reported outcomes. Walking speed was consistently reported as improved when using a hydraulic ankle-foot prosthesis as compared with a nonhydraulic ankle-foot prosthesis.