Immediate Effects of Heel Support Stiffness on Gait and Balance in Unilateral Transtibial Amputees Using Composite Carbon Foot: Exploratory Randomized Crossover Trial


Dilmen E., Özçelep Ö. F., TARAKCI D., ATILGAN E.

Journal of Prosthetics and Orthotics, 2026 (ESCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1097/jpo.0000000000000642
  • Dergi Adı: Journal of Prosthetics and Orthotics
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, SportDiscus, Academic Search Ultimate (EBSCO)
  • Anahtar Kelimeler: balance control, below-knee amputation, carbon composite prosthetic foot, heel support stiffness, spatiotemporal gait parameters
  • İstanbul Medipol Üniversitesi Adresli: Evet

Özet

Background: – Heel support stiffness is routinely adjusted during prosthetic alignment, yet its acute effects on balance and gait in high-functioning individuals with transtibial (TT) amputation using advanced prosthetic systems remain unclear. Objectives: – To investigate the immediate effects of different heel support stiffness conditions on static balance, functional performance, spatiotemporal gait parameters, and static load line alignment. Study Design: – Exploratory randomized crossover trial. Methods: – Fifteen male individuals with unilateral TT amputation using composite carbon feet were assessed under three randomized conditions: black wedge, white wedge, and no wedge. Outcomes included clinical balance and functional performance tests, spatiotemporal gait analysis using an instrumented walkway, and static alignment assessment. Results: – Single-leg stance duration was significantly increased in the no-wedge condition compared with both wedge conditions (P < 0.05). No significant differences were observed among conditions for other functional tests, spatiotemporal gait parameters, static load line alignment, or order effects (P > 0.05). Conclusion: – This exploratory trial suggests that acute changes in heel support stiffness have minimal effects on dynamic gait but may influence static postural control in high-functioning individuals with TT amputation. Balance-focused assessments may therefore enhance prosthetic optimization. Clinical Relevance: – This study helps clinicians provide informed alignment decisions by highlighting the sensitivity of static balance to heel stiffness adjustments. (J Prosthet Orthot. 2026;X:XX–XX)