A passive dorsiflexing ankle prosthesis to increase minimum foot clearance during swing.

Abstract

The biological ankle dorsiflexes several degrees during swing to provide adequate clearance between the foot and ground, but conventional energy storage and return (ESR) prosthetic feet remain in their neutral position, increasing the risk of toe scuffs and tripping. We present a new prosthetic ankle intended to reduce fall risk by dorsiflexing the ankle joint during swing, thereby increasing the minimum clearance between the foot and ground. Unlike previous approaches to providing swing dorsiflexion such as powered ankles or hydraulic systems with dissipative yielding in stance, our ankle device features a spring-loaded linkage that adopts a neutral angle during stance, allowing ESR, but adopts a dorsiflexed angle during swing. The ankle unit was designed, fabricated, and assessed in level ground walking trials on a unilateral transtibial prosthesis user to experimentally validate its stance and swing phase behaviors. The assessment consisted of three conditions: the ankle in an operational configuration, the ankle in a locked configuration (unable to dorsiflex), and the subject's daily use ESR prosthesis. When the ankle was operational, minimum foot clearance (MFC) increased by 13 mm relative to the locked configuration and 15 mm relative to his daily use prosthesis. Stance phase energy return was not significantly impacted in the operational configuration. The increase in MFC provided by the passive dorsiflexing ankle prosthesis may be sufficient to decrease the rate of falls experienced by prosthesis users in the real world.