The Effects of Prosthetic Knee Joints During Walking on Different Types of Surfaces: A Preliminary Study

Abstract

Individuals with transfemoral amputation continue to face mobility challenges despite the advancements in prosthetics technology. Generally, a mechanical prosthetic knee joint is prescribed to replace the important role of the anatomic knee joint in providing an effective walking process. However, research on assessing the biomechanical advantages or disadvantages of various mechanical knee joint designs is yet to be conducted. The objective of this study was to analyze the dual-task gait assessment of transfemoral amputees between two groups of prosthetic knees (polycentric, TFAP; and fluid-controlled, TFAFC) on different types of surfaces (even and uneven), by comparing them to the age-matched able-bodied group. All participants walked at their self-selected pace along a 5-m walkway. Primary outcomes consisted of temporal-spatial, kinetics, kinematics of the lower limb and descriptive analysis was performed in this study. The findings demonstrated that people with TFA walked slower with longer stride and step times, shorter stride and step lengths, with reduced vertical GRF and range of motion compared to the able-bodied participants in all conditions. The effects were much greater in the TFAP group than the TFAFC group in most conditions. In comparison between types of surfaces, the performance in dual-task gait assessment on the even surface is better than the uneven surface for all participants. The stance phase duration of the prosthetic leg was shorter than the able-bodied. Results indicated that the quality of gait deteriorates in challenging walking conditions for both able-bodied and people with TFA, but fluid-controlled prosthetic knee users have better performance compared to polycentric prosthetic knee users.