@2024 Afarand., IRAN

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ISSN: 2008-2630    Iranian Journal of War & Public Health 2014;6(3):73-79

Background
… [1] Before 1980s, most of the prosthetic feet were designed for basic walking and performing simple activities [2]. Nevertheless, the amputees’ wish to participate in sport activities, as well as many athletes’ needs, resulted in enhancement of a new generation of feet, named as “energy storing”, which were able to perform more dynamic motions than older simple feet [2]. This new feet called as dynamic prostheses [1], DER (dynamic elastic response) [3, 4], and ESPF (energy saving prosthesis foot) [2, 5, 6], saves energy at the beginning of stance phase, and returns it to the person at the end of the stance phase (through the beginning of walking). In this way, it helps body to move forwards involuntarily [1-4]. Energy consumption amount of the lower limb amputated persons is more than that of normal persons, and this amount increases with the level of amputation [7]. Seattle, SAFE, STEN, Dynamic, Quantum, TruStep, Carbon Copy Ц, Reflex VSP, Spriglite advantage DP, and Ohio Willow Wood Pathfinder, can be mentioned as examples [2, 8-14].
Previous Studies
Several studies were done regarding these feet. Nevertheless, the main problem in this context is the difference in measurement methods for energy storage and return.
Aim(s)
The aim of the study was to explain and expand the concept of energy and the terms related to energy transportation in prosthesis, as well as an overview of measurement of prosthetic energy saving and returning amount.
Research type
This is an overview study.
Research society, place and time
Non-declared
Sampling method and number
First, a systematic research was done in Google Scholar and PubMed databases, leading to 54 published papers concerning this field since 1950 up to 2013; and 23 papers in English were selected for final assessment, considering inclusion and exclusion criteria of the study Only the papers in which the subjects, had lost their foot due to the trauma, , and amputation was from cross section of the tibia were assessed. In addition, the cases were able to walk independently and without assistive device. The patients had no neural, cardiovascular, or musculoskeletal disorder, and their residual limb had no skin complication, pain, sensitivity, or volume change. In addition, method for energy measurement was fully described in the selected papers.
Used devices&materials
Used keywords included various combinations and synonymous of words such as Energy Storing Prostheses, Energy Storing and Returning, Energy Analysis, and Energy Measurement. To expand the scope of searches and to include more articles, MESH (medical subject headlines) was used. Finally, PEDro tool was used to assess the quality of studies. This scale allocates the grades between 1 and 10 to the papers, based on 10 determined standards. To assess papers, using PEDro tool, if a paper is scored by 6 or more, then it means that the mentioned study has high quality; otherwise, it has a low quality. The credit and accuracy of the test has been proved as a tool to assess quality of the studies [15-17].
Findings by Text
The results obtained from the articles were classified in the “attention to energy concepts and terms related to energy transportation”, “to evaluate methods for energy analysis in prosthetic foots”, and “to evaluate functional classifications and naming prosthetic foots with energy storing ability”. Energy cocept and terms related to energy transfer To ease, the prosthetic foot can be considered as a simple mechanical spring. During walking, body weight results in loading and compression of the spring. This energy is stored, and finally, it will be released as work. Work is computed as an integral of force-deformation (muscle strength) curve; and area under the curve shows potential energy of the compressed spring. Studying ESAR (elastic energy accumulator and restorer) prostheses, many researchers have considered entry work during various phases of walking as energy. Since there is no possibility to measure the general deformation of the prosthesis’ inner system (springs) directly, the value of stored and returned energy by prosthesis is computed through integral taking of time-power curve of the ankle joint, which is obtained from motion analysis systems. Actually, motion analysis software can estimate the power of the joint using force-plate data and other kinematic information [18, 19]. Methods of energy analyzing in prosthetic foots Functional analysis is the simplest method to determine energy characteristics in prosthetic pieces, in which a simple functional test, alongside computer analyses were employed [20]. In mechanical analysis, the prosthesis undergoes force inside a mechanical press, which continuously records force value and deformation. In this system, foot’s energy loss value is proportional with walking foot’s energy loss value [21]. Kinetic analysis is the most common method to assess prosthesis’ structure concerning energy storing and returning. The power of joint can be estimated through many motion analysis applications, using gained kinetic and kinematic data (the ankle joint torque and its angular velocity) [21-23]. The stored and released energy of the prosthesis is evaluated through integral computing of power flow at one specified point of the prosthesis in time, [24]. Functional classification and naming ESPF (energy saving prosthetic foot) and DER (dynamic elastic response) are the two most common terms, to describe prosthetic feet with energy storing and returning ability. EPF was used for the first time in the late 1980s with a different design compared to the SACH older foot [25-33].
Main comparison to the similar studies
Non-declared
Suggestions
Non-declared
Limitations
Non-declared
Conclusions
Prosthesis analysis helps us to find out the function of prosthesis. Nevertheless, it is not enough to analyze the function of the amputee entirely. One of the major issues to analysis prosthesis energy transportation is appropriate value for the absorption and release of energy for the person, as well as impacts of the energy transportation on amputee. In addition, this question remains unanswered that whether receiving less energy is proper for the amputee, or receiving more energy.. It is vital to consider the optimal performance and health of the amputee as the final aim to design these types of prosthesis.
Acknowledgments
Researchers feel grateful to all who aided them to conduct this study.
Conflict of interest
Non-declared
Ethical Permissions
Non-declared
Funding Sources
Non-declared