A Study of the Effect of the Difference in Energy Stored in Two Prosthetic Feet Made of Carbon Fiber Amputated Below the Knee on the Efficiency of Walking


  • Noor Basim Department of Prosthetics and Orthotics Engineering, Al-Nahrain University, Baghdad, Iraq.
  • Yassr Y. Kahtan Department of Prosthetics and Orthotics Engineering, Al-Nahrain University, Baghdad, Iraq.




Prosthetic foot, Energy storing, Podium, G-Walk, P-Walk


ESAR feet are prosthetic feet with carbon fiber parts that store mechanical energy while standing and release it during propulsion. It is believed to reduce the metabolic energy needed for walking, and to promote the economy of walking. However, there is little scientific evidence to support this claim. This study aimed to compare the energy storage properties of two prosthetic feet made of carbon fiber using the P-Walk, G-Walk, and Podium devices developed for gait analysis, which is a systematic examination of human movement, enabling phasing, estimation of musculoskeletal performance, and determination of kinematic and motor parameters. The amount of energy was calculated for each of the feet using the load deflection test, and the results showed that the new artificial foot with an energy of 6.186 joules showed a great improvement in the results of the tests compared to the old artificial foot with an energy of 3.403 joules. The Podium device tests showed a significant improvement in walking patterns and pressure distribution after using a new foot. The pressure distribution became almost equal on both sides, and the angular deviation of COP decreased from -7 to 1.3 degrees. Ground reaction force vector tilt results also improved, with a body angle of 0 degrees and inclination varying slightly depending on the tibiofemoral angle for males. P-Walk results reveal left-sided static test pressure distribution, exposing amputees to osteoarthritis risk and revealing lack of confidence in prosthetic foot. After use the new prosthetic foot, amputees press more on right foot, indicating balance restoration. The G-Walk device shows the effectiveness of both healthy left and prosthetic foot when walking on an amputated right leg when use the new prosthetic foot. The amputated side's performance is similar to a healthy limb, with minimal difference and within normal limits. Walking cadence and speed values are within normal ranges, while stride length and step length are outside normal ranges for both sides. Obliquity results show a small difference in pelvic angles due to weak pelvic muscles, but these are close to standard values for prosthetic foot use. The amputee's opinions about the evaluation of the new prosthetic foot were good when using the T-score by 61.0 with a rate of 86.4%. It was a significant improvement compared to the old foot with an evaluation of 53.6 by 63.9%.


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Han Houdijk, Daphne Wezenberg, Laura Hak and Andrea Giovanni Cutti, "Energy storing and return prosthetic feet improve step length symmetry while preserving margins of stability in persons with transtibial amputation", Journal of Neuro Engineering and Rehabilitation, 2018.

Joel Zagoya-López, Luis Adrián Zúñiga-Avilés, Adriana H. Vilchis-González and Juan Carlos Ávila-Vilchis, "Foot/Ankle Prostheses Design Approach Based on Scientometric and Patentometric Analyses", Applied Sciences, 2021.

Wezenberg D, Cutti AG, Bruno A, Houdijk H, "Differentiation between solid-ankle cushioned heel and energy storage and return prosthetic foot based on step-to-step transition cost", J Rehabil Res Dev, Vol. 51(10), pp. 1579–89, 2014.

Roy Mu¨ller, Lisa Tronicke, Rainer Abel, Knut Lechler, "Prosthetic push-off power in trans-tibial amputee level ground walking: A systematic review", PLOS ONE, 2019.

Fey NP, Klute GK, Neptune RR, "Altering prosthetic foot stiffness influences foot and muscle function during below-knee amputee walking: a modeling and simulation analysis", J Biomech, Vol. 46(4), pp. 637–44, 2013.

Hak L, van Dieen JH, van der Wurff P, Houdijk H,"Stepping asymmetry among individuals with unilateral Transtibial limb loss might be functional in terms of gait stability", Phys Ther, Vol. 94(10), pp. 1480–8,2014.

Thiago Braga Rodrigues, Debora Pereira Salgado, Ciarán Ó Catháin, Noel O’Connor, Niall Murray," Human Gait Assessment using a 3D Marker-less Multimodal Motion Capture System," 2019.

Barbara Nesi, Antonio Taviani, Lucia D’ Auria, Roberta Bardelli, Giuseppe Zuccarello, Daniela Platano, Maria Grazia Benedetti and Francesco Benvenuti, "The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients”, Applied Sciences, 2023.

Dimple Sethi, Sourabh Bharti, Chandra Prakash, "A comprehensive survey on gait analysis: History, parameters, approaches, pose estimation, and future work", Elsevier, 2022.

Bence Rochlitz, Dávid Pammer, "Design and Analysis of 3D Printable Foot Prosthesis", Periodica Polytechnica, Mechanical Engineering, 61, 282-287, 2017.

Bahjat R. J. Muhyedeen," New Concept of Mass-Energy Equivalence", European Journal of Scientific Research, Vol.26 No.2, pp.161-175,2009.


by Isaia Andrenacci, Riccardo Boccaccini, Alice Bolzoni, Giulio Colavolpe, Cosimo Costantino, Michelangelo Federico, Alessandro Ugolini andArmando Vannucci, "A Comparative Evaluation of Inertial Sensors for Gait and Jump Analysis", Sensors, Vol. 21, pp. 5990, 2021.

https://plus-m.org/files/PLUS_M_Users_Guide_v1.0.pdf, Prosthetic Limb Users Survey of Mobility (PLUS-M™) Version 1.0, 2014.

Olivier Beauchet, Gilles Allali, Harmehr Sekhon, Joe Verghese, Sylvie Guilain, Jean-Paul Steinmetz, Reto W. Kressig, John M. Barden, Tony Szturm, Cyrille P. Launay, Sébastien Grenier, Louis Bherer, Teresa Liu-Ambrose, Vicky L. Chester, Michele L. Callisaya, Velandai Srikanth, Guillaume Léonard, Anne-Marie De Cock, Ryuichi Sawa, Gustavo Duque, Richard Camicioli and Jorunn L. Helbostad , "Guidelines for Assessment of Gait and Reference Values for Spatiotemporal Gait Parameters in Older Adults: The Biomathics and Canadian Gait Consortiums Initiative", Frontiers in Human Neuroscience, 2017.

Rolf Moe-Nilssen, Jorunn L. Helbostad, "Spatiotemporal gait parameters for older adults – An interactive model adjusting reference data for gender, age, and body height", Gait & Posture, 2020.

Ágnes Mayer, József Tihanyi, Károly Bretz, Zsolt Csende, Éva Bretz, and Mónika Horváth, "Adaptation to altered balance conditions in unilateral amputees due to atherosclerosis: a randomized controlled study", BMC Musculoskelet Disord, 2011.

Michael W. Whittle, "Chapter 3 - Pathological and other abnormal gaits", Gait Analysis, Fourth Edition, 2007.

Kenneth A. Krackow, M.D, "The Measurement and Analysis of Axial Deformity at The Knee ", 2008.

Alena M Grabowski and Susan D’Andrea, "Effects of a powered ankle-foot prosthesis on kinetic loading of the unaffected leg during level-ground walking", Journal of NeuroEngineering and Rehabilitation, 2013.

Bogdan Pietraszewski, Slawomir Winiarski, Sebastian Jaroszczuk, "Three-dimensional human gait pattern - Reference data for normal men", Acta of Bioengineering and Biomechanics, 2012.

Eva C Wentink, Erik C Prinsen, Johan S Rietmanand Peter H Veltink, "Comparison of muscle activity patterns of transfemoral amputees and control subjects during walking”, Journal of NeuroEngineering and Rehabilitation, 2013.




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