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  • Title: Assessment of low- and high-level task performance in people with transtibial amputation using crossover and energy-storing prosthetic feet: A pilot study.
    Author: Halsne EG, McDonald CL, Morgan SJ, Cheever SM, Hafner BJ.
    Journal: Prosthet Orthot Int; 2018 Dec; 42(6):583-591. PubMed ID: 29779442.
    Abstract:
    BACKGROUND:: Crossover feet incorporate features of energy-storing feet and running-specific feet. As such, crossover feet may be suitable for both daily ambulation and participation in physically demanding activities. OBJECTIVES:: To compare crossover feet and energy-storing feet on performance-based tests including a range of low-level (e.g. sit-to-stand) and high-level (e.g. jogging) activities. STUDY DESIGN:: Cross-sectional, repeated measures. METHODS:: Participants with transtibial amputation completed a battery of performance-based outcome measures, including the Five Times Sit-to-Stand, Timed-Up-and-Go, Four Square Step Test, and the Comprehensive High-level Activity Mobility Predictor. Participants wore duplicate prostheses fit with crossover feet and energy-storing feet to perform the tests; the order of foot conditions was randomized. Paired t tests were used to evaluate differences between feet and order of testing. RESULTS:: Data from seven participants showed improvements in all measures while using crossover feet. Improvements in the second foot condition were also observed, indicating a practice effect for all measures. However, differences between feet and order of conditions were not statistically significant ( p > 0.05). CONCLUSION:: Results of this study suggest that crossover feet may improve low- and high-level mobility outcomes. However, intervention effects are small and practice effects were observed in all outcomes. Future research is needed to evaluate the influence of practice effects on performance-based mobility measures. CLINICAL RELEVANCE: Crossover feet may improve transtibial prosthesis users' performance compared to energy-storing feet across a range of activities, but additional research is needed. Practice effects may be an influential factor in the measurement of performance-based mobility outcomes and should be considered when performing a clinical assessment.
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