Effectiveness of a crossover prosthetic foot in active children with a congenital lower limb deficiency: an explorative study.

BACKGROUND: Children with lower limb prostheses cannot always keep up with their peers during active play. A pediatric crossover foot may be a promising prosthetic alternative for children engaging in high-intensity movements necessary for active play. OBJECTIVES: To compare children's walking performance, running performance, experienced competence, and cosmesis using their prescribed prosthesis compared with the crossover foot. STUDY DESIGN: Pretest-posttest study. METHODS: Children with lower limb amputation or deficiency were recruited. Measurements were taken at baseline with the prescribed prosthesis and 6 weeks later with the crossover foot. Walking speed, energy cost of walking, anaerobic muscle power, stair climbing speed, ankle power, and cosmesis were evaluated. RESULTS: Four children participated in the study. Two children had increased walking speed with the same energy cost, one child had decreased speed with increased energy cost, and one child had the same speed with decreased energy cost. Muscle power increased for three of the four children and ankle power increased for all children while using the crossover foot compared to the prescribed prosthesis. Two children reported knee pain or feeling excessive knee flexion when running with the crossover foot. One child reported negative feelings toward cosmesis of the crossover foot. CONCLUSIONS: This study suggests crossover foot may benefit active children by improving walking and running performance, and decreasing energy cost. However, knee pain reports or negative feelings toward the atypical design suggest the crossover foot may not be ideal for every child. Further research is needed to determine which pediatric users would benefit from this type of prosthetic foot. CLINICAL RELEVANCE: Children with lower limb deficiencies are active prosthetic users who often switch between low- and high-intensity movements in their daily activities. Therefore, they might benefit from a crossover prosthetic design. The preliminary findings of this study suggest the crossover foot (XF) may be a promising foot for active children.

The effect of surface electric stimulation of the gluteal muscles on the interface pressure in seated people with spinal cord injury.

OBJECTIVE: To study effects of surface electric stimulation of the gluteal muscles on the interface pressure in seated persons with spinal cord injury (SCI). DESIGN: One session in which alternating and simultaneous surface electric stimulation protocols were applied in random order. SETTING: Research laboratory of a rehabilitation center. PARTICIPANTS: Thirteen subjects with SCI. INTERVENTION: Surface electric stimulation of the gluteal muscles. MAIN OUTCOME MEASURES: Interface pressure, maximum pressure, pressure spread, and pressure gradient for the stimulation measurement. Variables were compared using 2-tailed paired t tests. RESULTS: Alternating and simultaneous stimulation protocol caused a significant (P<.01) decrease in interface pressure (-17+/-12 mmHg, -19+/-14 mmHg) and pressure gradient (-12+/-11 mmHg, -14+/-12 mmHg) during stimulation periods compared with rest periods. There was no significant difference in effects between the 2 protocols. CONCLUSIONS: Surface electric stimulation of the gluteal muscles in persons with SCI causes a decrease in interface pressure. This might restore blood flow in compressed tissue and help prevent pressure ulcers.