Prosthetic restoration of the forefoot lever after Chopart amputation and its consequences onto the limb during gait

•The loss of the forefoot lever due to chopart amputation alters gait biomechanics.•Design and coupling of the prosthesis to the residual limb influence gait biomechanics.•The clamshell device allowed for most physiologic gait patterns except for the ankle.•The low profile prosthesis showed insuffic...

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Bibliographic Details
Published in:Gait & posture 2019-09, Vol.73, p.1-7
Main Authors: Kaib, T., Block, J., Heitzmann, D.W.W., Putz, C., Alimusaj, M., Wolf, S.I.
Format: Article
Language:English
Subjects:
Adult
Aged
Amputation
Ankle Joint
Artificial Limbs
Biomechanical Phenomena
Biomechanics
Chopart amputation
Female
Foot - surgery
Gait
Gait Analysis
Humans
Male
Middle Aged
Orthotic Devices
Prosthesis
Prosthesis Design
Range of Motion, Articular
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Description
Summary:•The loss of the forefoot lever due to chopart amputation alters gait biomechanics.•Design and coupling of the prosthesis to the residual limb influence gait biomechanics.•The clamshell device allowed for most physiologic gait patterns except for the ankle.•The low profile prosthesis showed insufficient foot leverage.•A ventral shell may be optimized for foot leverage and ankle joint range of motion. In subjects with Chopart amputation the foot lever is clearly diminished. Usually high or low profile prostheses are routinely utilized to re-establish the lost forefoot lever. The aim of this study was to investigate to what extent the proposed prostheses were able to replace the forefoot lever in chopart-amputees. An instrumented 3D gait analysis, including plantar and socket pressure measurements, was performed in thirteen subjects with Chopart amputation using a clamshell and/or a Bellmann prosthesis including an ankle foot orthosis during level ground walking. The largest range of motion (p 
ISSN:0966-6362
1879-2219
DOI:10.1016/j.gaitpost.2019.06.024