Development of a bimodal ankle-foot prosthesis for walking and standing/swaying

The human ankle-foot system conforms to a circular effective rocker shape for walking, but to a much flatter effective shape for standing and swaying. Many persons with lower limb amputations have impaired balance and reduced balance confidence, and may benefit from prostheses designed to provide flatter effective rocker shapes during standing and swaying tasks. This paper describes the development and testing of an ankle-foot prosthesis prototype that provides distinctly different mechanical properties for walking and standing/swaying. The prototype developed was a single-axis prosthetic foot with a lockable ankle for added stability during standing and swaying. The bimodal ankle-foot prosthesis prototype was tested on pseudoprostheses (walking boots with prosthetic feet beneath) for walking and standing/swaying loads, and was compared to an Otto Bock single-axis prosthetic foot and to able-bodied data collected in a previous study. The heightnormalized radius of the effective rocker shape for walking with the bimodal ankle-foot prototype was equal to that found earlier for able-bodied persons (0.17); the standing and swaying effective shape had a lower height-normalized radius (0.70) compared with that previously found for able-bodied persons (1.11). The bimodal ankle-foot prosthesis prototype had a similar radius as the Otto Bock single-axis prosthetic foot for the effective rocker shape for walking (0.17 for both), but had a much larger radius for standing and swaying (0.70 for bimodal, 0.34 for single-axis). The results suggest that the bimodal ankle-foot prosthesis prototype provides two distinct modes, including a biomimetic effective rocker shape for walking and an inherently stable base for standing and swaying. The radius of the prototype's effective rocker shape for standing/ swaying suggests that it may provide inherent mechanical stability to a prosthesis user, since the radius is larger than the typical body center of mass's distance from the floor (between 50-60% of height). Future testing is warranted to determine if the bimodal ankle-foot prosthesis will increase balance and balance confidence in prosthesis users.