Comparison of the International Committee of the Red Cross Foot With the Solid Ankle Cushion Heel Foot During Gait: A Randomized Double-Blind Study

Objective: To compare the well-recognized solid ankle cushion heel (SACH) foot with the prosthetic foot developed by the International Committee of the Red Cross (CR Equipements SACH) during gait. Design: Double-blind study was conducted to compare the influence on the biomechanics of gait of the CR Equipements SACH foot and the SACH foot. Setting: University hospital research center. Participants: Participants with unilateral transtibial amputation (N = 15) were included. Interventions: Three-dimensional motion analysis system and 2 forceplates were used to capture body motion and ground reaction forces during gait at a self-selected speed and at 1.2m/s. Main Outcome Measures: Nonparametric Wilcoxon matched-pairs tests were used to compare the 2 prosthetic feet with respect to their spatiotemporal (gait velocity, stride length, and percentage of stance phase), kinematic (range and peak angles of the pelvis, hip, knee, and ankle), and kinetic (peak moment and power of the hip, knee, and ankle) parameters. Results: Compared with the SACH foot, the CR Equipements SACH foot demonstrated a significantly greater stance phase symmetry ratio (SACH: 94% vs CR Equipements SACH: 97%), a more extensive ankle range of motion in the sagittal plane (SACH: 7 degrees vs CR Equipements SACH: 12 degrees), a greater maximal dorsiflexion angle during the terminal stance phase (SACH: 10 vs CR Equipements SACH: 13 degrees), and a higher ankle power (SACH: .31W/kg vs CR Equipements SACH: .40W/kg). No significant difference was found for the examined knee, hip, and pelvis parameters. Conclusions: The CR Equipements SACH foot provides more symmetry and improves ankle kinematics and kinetics in the sagittal plane compared with the SACH foot. This study suggests that individuals using the CR Equipements SACH foot improve their gait biomechanics compared when using the SACH foot. (c) 2013 by the American Congress of Rehabilitation Medicine