Biomechanical evaluation of SACH and uniaxial feet.

A review of prosthetic prescription practice reveals that in the United Kingdom about 85% of below and above-knee amputees are fitted with uniaxial feet, whereas in the United States about 80% are fitted with SACH feet. An evaluation method was developed to assess the performance of these two different types of feet. This included a subjective assessment procedure and a biomechanical evaluation of the function of the two feet and their effects on whole body gait kinematics and lower limb kinetics. Data were acquired by three Bolex H16 cine cameras and two Kistler force plates. This set-up allowed three-dimensional analysis on the prosthetic and contralateral sides of the subject. Investigations were undertaken in which an experimental prosthesis permitted the interchange of the ankle/foot while keeping the rest of the components the same. Altogether, six below knee and five above knee amputees were tested. No clear trend for preference for either type of foot was evident from the subjective survey; in general the patients showed a preference for the foot that they were accustomed to. Kinematic and kinetic analysis showed some differences in the function between the two prosthetic feet. It is the purpose of this paper to discuss these differences and their significance.