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Current energy storage and return prosthetic feet only marginally reduce the cost of amputee locomotion compared with basic solid ankle cushioned heel feet, possibly due to their lack of push-off at the end of stance. To the best of our knowledge, a prosthetic ankle that utilizes a hydraulic variable displacement actuator (VDA) to improve push-off performance has not previously been proposed. Therefore, here we report a design optimization and simulation feasibility study for a VDA-based prosthetic ankle. The proposed device stores the eccentric ankle work done from heel strike to maximum dorsiflexion in a hydraulic accumulator and then returns the stored energy to power push-off. Optimization was used to establish the best spring characteristic and gear ratio between ankle and VDA. The corresponding simulations show that, in level walking, normal push-off is achieved and, per gait cycle, the energy stored in the accumulator increases by 22% of the requirements for normal push-off. Although the results are promising, there are many unanswered questions and, for this approach to be a success, a new miniature, low-losses, and lightweight VDA would be required that is half the size of the smallest commercially available device.
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http://dx.doi.org/10.1109/TNSRE.2017.2763999 | DOI Listing |
BMC Musculoskelet Disord
September 2025
Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
Introduction: 3D-printing is an emerging technology that is used in the manufacturing of orthotic devices. 3D-printing has many advantages such as improved fit, comfort, effectiveness, and patient satisfaction. While some challenges like durability and material selection remain, the aim of this systematic review is to provide a comprehensive evaluation of the clinical outcomes of 3D-printed orthoses.
View Article and Find Full Text PDFGait Posture
August 2025
Clinical Research and Services, Research Biomechanics, Ottobock SE & Co. KGaA, Göttingen, Germany; HAWK University of Applied Sciences and Arts, Göttingen, Germany. Electronic address:
Background: Prosthetic fittings for persons with a transfemoral amputation should provide adequate ground clearance (GC) during prosthetic side swing to minimize the risk of stumbling or falling. Insufficient ground clearance often leads to compensatory movements that consequently influence gait biomechanics negatively.
Research Question: How do different prosthetic components and alignment of a transfemoral prosthesis affect prosthetic side GC and compensatory strategies during level walking?
Methods: Eight persons with transfemoral amputation were enrolled.
Cochrane Database Syst Rev
August 2025
Department of Research, Sint Maartenskliniek, Nijmegen, Netherlands.
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of different prosthetic ankle-foot mechanisms for improving health-related quality of life, functional, and biomechanical outcomes in adult prosthesis users after major lower limb amputation.
View Article and Find Full Text PDFIEEE Trans Neural Syst Rehabil Eng
September 2025
Hip disarticulation (HD) amputees face mobility challenges due to the loss of hip, knee, and ankle joints. Current hip-knee-ankle-foot (HKAF) prostheses are entirely passive and require excessive compensatory movements to operate, leading to fatigue and long-term complications. Seeking to address these limitations, this study developed a HD user-centric, walking speed adaptable control strategy paired with a hip-motorized HKAF to emulate gait characteristics of transfemoral amputees.
View Article and Find Full Text PDFJ Foot Ankle Surg
August 2025
Istituto Ortopedico Rizzoli, Bentivoglio Unit, via Pupilli 1, Bologna, IT. Electronic address:
Heterotopic periarticular ossifications (HO) are a frequent short to mid-term complication following Total Ankle Replacement (TAR). Historically two primary surgical approaches exist-Lateral Approach (LA) and Anterior Approach (AA)-each bound with different prosthetic designs. However, there is no consensus on the incidence, real clinical impact, or need for reintervention of HO between these approaches, nor on the necessity of prophylactic treatments.
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