Functional performance and quality of life in transtibial amputees is influenced by the type of prosthesis

Purpose/Hypothesis: Lower limb amputees may receive a prosthetic limb based on their functional ability, known as a K-level, ranging from least functional, K0 to most functional K4. The purpose of this study was to evaluate effects of two types of prosthetic feet on balance, walking performance and quality of life in transtibial amputees classified as either K2 or K3. Number of subjects: Seven males and three female, aged 48 to 69 years old with transtibial amputations due to peripheral neuropathy or type II diabetes have completed the study; enrollment is ongoing. Materials/Methods: Study participants are transtibial amputees secondary to diabetes, trauma, or vascular disease currently ambulating with either a K2 or K3 prosthesis. Quality of life was established using SF 36 and the Reintegration to Normal Living Index. Clinical tests: Timed Up and Go, Short Physical Performance Battery, Dynamic Gait Index and Activity Specific Balance Confidence Scales were administered. The V-gait CAREN system measured standing balance sway, gait speed, walking kinematics and kinetics on level ground and on a 4.8 degree ramp. The Physiological Cost Index was calculated for level and ramp walking. Participants completed all test with their current prosthesis and then switched prosthesis types in order to determine immediate effects of switching. Participants were then randomized into groups for a 2-week trial period to evaluate prosthetic foot that are either at, above or below their current functional level. Results were analyzed with pared t-tests. Results:Baseline quality of life, balance, and gait measures for participants currently ambulating with a K2 vs k3 were significantly lower (p Conclusions: Preliminary results suggest that K3 prosthetic feet lead to greater quality of life and functional performance. A higher functioning prosthesis for lower functioning amputees may lead to less injuries and falls due to improved balance and coordination, and it may also improve cost effectiveness.