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Presentation on prosthetic foot

The document presents an overview of various types of prosthetic feet, including their designs, functions, and classifications. It discusses specific prosthetic feet like the Jaipur foot and SACH foot, comparing their features, advantages, and limitations. Additionally, it covers the purpose of prosthetic feet in replicating the anatomical function of a human foot while emphasizing the importance of cosmesis and shock absorption.

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PRESENTATION ON PROSTHETIC FOOT By Aamir Siddiqui
CONTENTS INTRODUCTION PURPOSE OF PROSTHETIC FOOT FUNCTIONS OF PROSTHETIC FOOT CLASSIFICATION OF PROSTHETIC FOOT JAIPUR FOOT SACH FOOT & IT’S TYPES SACH FOOT V/S JAIPUR FOOT STEN FOOT MECHANICAL FOOT & IT’S TYPES FLEXIBLE-KEEL DYNAMIC RESPONSE FOOT SPRINGLITE FOOT NON-ARTICULATED SHORT-KEEL FOOT & IT’S TYPES ARTICULATED DYNAMIC RESPONSE FOOT ADVANCED PROSTHETIC FOOT
INTRODUCTION Current prosthetic foot designs do not replicate the exact characteristics of a normal foot. A human foot is a multi-functional device that can be used to perform a wide range of activities, however a prosthetic foot is limited to only a few. More recently, manufacturers of prosthetic feet have looked into the characteristics of a prosthesis that may be adjustable. The amputee may then able to perform number of activities without requiring a different prosthesis. Prosthetic foot provide essential connection between prosthesis and ground Currently divided into traditional foot classifications: SACH FLEXIBLE KEEL SINGLE AXIS MULTI AXIS DYNAMIC RESPONSE
PURPOSE OF PROSTHETIC FOOT The purpose of prosthetic foot is to serve in place of anatomical foot in terms of cosmesis and functions. Cosmesis : prosthetic foot looks like an anatomical foot. Functions like walking , balancing etc.
FUNCTIONS OF PROSTHETIC FOOT Joint simulation : By helping in dorsiflexion & plantarflexion By helping in inversion & eversion Smooth roll over during heel off & toe off. All these movements of prosthetic foot simulates the anatomical foot and thus provides us smooth, more natural and low energy expenditure gait pattern. Shock Absorption: -The foot must absorb the impact of heel strike and weight acceptance without transmitting excessive forces to the residual limb. Too much shock absorption, in contrast, might fail to generate the normal knee flexion when the foot is flat and result in an unacceptable gait pattern. moment A stable weight-bearing base of support Muscle simulation Cosmesis: While function of the prosthetic foot is of primary concern to the prosthetist, the importance of cosmesis cannot be overlooked. The design of a particular foot may enhance or diminish its cosmetic appeal.
CLASSIFICATION OF PROSTHETIC FOOT PROSTHETIC FOOT CONVENTIONAL FOOT JAIPUR FOOT STEN FOOT SAFE FOOT SINGLE AXIS DOUBLE-AXIS MULTI-AXIS SACH FOOT DYNAMIC RESPONSE FOOT NON-ARTICULATED FOOT LONG KEEL NON- ARTICULATED FLEX FOOT SPRINGLITE FOOT SABOLITCH FOOT SHORT KEEL NON- ARTICULATED SEATTLE FOOT CC II FOOT QUANTUM FOOT DYNAMIC FOOT ARTICULATED FOOT TRUSTEP FOOT
JAIPUR FOOT • The Jaipur Foot, also known as the Jaipur Leg. • It is a rubber-based prosthetic leg for people with below- knee amputations. Although inferior in many ways to the composite carbon fibre variants, its variable applicability and cost efficiency make it an acceptable choice for prosthesis. • Ram Chander Sharma designed and developed it in 1968 • It is a foot piece of same contour (shape) as a human foot with fingers. • It can be used without shoes for base foot walking. • Mostly used by people who belongs to rural background. • It has wide range of motion such as plantarflexion, dorsiflexion, inversion & eversion helps in cross legged position.
MATERIAL REQUIRED FOR JAIPUR FOOT • Ordinary MCR ( Micro Cellular Rubber ), • Rubber Cord, • Rubber Cushion, • Skin Coloured Rubber, • Dyes, and • Stationary ankle
ADVANTAGES OF JAIPUR FOOT • It doesn’t require shoes & has certain degree of cosmetic acceptance by amputee. • It permits certain degree of transverse rotation to facilitate gait • Easily available and cheap. • Made up of waterproof material. • Raw materials used for making Jaipur Foot is easily available. • In appearance, it mimics a real foot.
SACH FOOT It was first manufactured by University of California in 1947. SACH stands for Solid-Ankle Cushion-Heel Feet. Introduced in 1956 by Radcliffe and Foort. The light weight, durability, low cost, and cosmesis of the SACH foot make it the single most frequently recommended prosthetic foot.  Although recent innovations in prosthetic foot design may change this, the SACH foot has been the traditional foot of choice for children and for the majority of adult patients with transtibial or ankle disarticulation amputations. They are available for multiple shoe styles and heel heights, postoperative uses, Syme's fittings, external-keel "waterproof' fittings, and pediatric sizes. The cushioned heel compressed under loading to stimulate ankle plantarflexion and the eccentric contraction of the ankle dorsiflexors during loading response.
ADVANTAGES & DISADVANTAGES OF SACH FOOT ADVANTAGES Smooth, Durable, Light Weight, Requires little maintenance, Higher degree of acceptance by amputee, and Psychologically accepted by women & children, Good shock absorption for moderately active patients. DISADVANTAGES Lack of ability to absorb the torque produced during locomotion, Limited range of plantarflexion, The heel cushion deteriorates over time, The heel cushion may loose elasticity, The rigid forefoot provides poor shock absorption for high- output activities.
TYPES OF SACH FOOT SACH FOOT STANDARD SACH FOOT POST-OPERATIVE SACH FOOT SYME SACH FOOT EXTERNAL-KEEL SACH FOOT
STANDARD SACH FEET Also known as Internel-Keel Sach Foot. Internal-keel SACH feet include a solid wood or aluminum internal keel that extends to the toe break and is surrounded by a molded external foam foot with cosmetic toes and a cushioned heel wedge available in different densities.
POSTOPERATIVE SACH FOOT The postoperative SACH foot is designed so that the patient can walk without shoes or in slippers.  As the name implies, its primary use is on postoperative or temporary prostheses.  It has no heel rise, and since no shoes are worn, the postoperative foot has a wider sole than a standard SACH foot to provide more stability. The molded rubber foot and heel are softer, which makes the postoperative foot very shock absorbent.
SYME SACH FOOT The Syme SACH foot was designed to provide the ankle disarticulation amputee with the advantages of a SACH foot. Since an ankle disarticulation in an adult results in only an average I½ in. shortening of the leg, the space available for the addition of a prosthetic foot is limited. The Syme foot, therefore, is lower in height than the SACH foot in order to accommodate this minimal ground clearance. Important to note is the thinner heel cushion. Because the foot height is reduced, the heel cushion is also reduced and therefore less shock absorbent.
EXTERNAL-KEEL SACH FOOT In the external-keel SACH foot the keel portion is not incorporated within the rubber foot. Instead, the rubber portion of the foot is affixed to the keel. It is used for exoskeletal prostheses only. This foot is recommended for a Syme prosthesis when an internal-keel foot will not accommodate a minimal leg length discrepancy. The need for optimum cosmesis at the ankle on an exoskeletal prosthesis may also be an indication for an external-keel SACH foot. The foot's wider keel makes it ideal for patients who require added stability, although an attempt should be made to gain stability through prosthetic alignment first. The external-keel SACH foot also permits the prosthesis to be made waterproof.
JAIPUR FOOT V/S SACH FOOT SACH FOOT On the basis of appearance SACH foot doesn’t look like a normal foot. SACH foot requires a closed shoe to protect as well as hide it. JAIPUR FOOT On the basis of appearance It looks like a normal foot No such need or requirement with Jaipur Foot. But in case someone wants to wear a shoe, he can do it comfortably with a flat heel shoe.
JAIPUR FOOT V/S SACH FOOT JAIPUR FOOT On the basis of Movements & ADL Cross- legged sitting is possible because sufficient forefoot adduction & transverse rotation of foot in relation to shank is available. Squatting is easily achieved. Bare-Foot walking is possible. As transverse rotation of foot in relation to leg is possible, no complaint of discomfort while walking on uneven ground. SACH FOOT On the basis of Movements & ADL No cross-leg sitting is possible because it requires adduction at forefoot & transverse rotation of foot in relation to shank. Squatting is not possible. Bare-Foot walking is not possible Great discomfort is complained by amputees while walking on uneven surface.
STEN FOOT The STEN foot is one of the simplest designs in prosthetic feet for it uses the Kingsley foot moulds and rubbers. It comes in a wide variety of sizes and heel heights from a child (18cm keel) through to an adult (30cm keel). The heels also come is soft, medium or hard densities. Although it is slightly heavier than the conventional SACH foot, it differs in its keel which allows for smooth roll - over of the prosthesis. As the name suggests the STEN, STored ENergy, has the capacity to store energy. However, the effectiveness of its ability to store energy is debatable. The structure of its keel disperses the energy rather than storing and then returning it. The STEN Foot is characterised by its : • Varying density heel • Polyurethane bumpers • Reinforcement bands
ADVANTAGES & DISADVANTAGES OF STEN FOOT ADVANTAGES Allows motion that stimulates to the anatomical foot. It can be accommodated into different shoe types / styles. DISADVANTAGES Expensive Not at all recommended for heavy-weight amputees.
SAFE FOOT SAFE stands for STATIONARY ATTACHMENT FLEXIBLE ENDOSKELETAL foot. The SAFE Foot (Stationary Ankle Flexible Endoskeleton) has a solid ankle and provides large amounts of transverse rotation as well as inversion and eversion. The advantage of the SAFE Foot is that it is moisture and grit - resistant. This makes this prosthesis very low maintenance The SAFE foot and other soft keel designs should be viewed as offering increased shock absorption and comfort at the expense of responsiveness in a competitive situation.
ADVANTAGES & DISADVANTAGES OF SAFE FOOT ADVANTAGES • Little maintenance required, • Moisture resistant, • Adjustable heel height, • Pediatries size available. DISADVANTAGES • Less medio-lateral stability, • Poor push-off at the end of stance phase.
CONEVNTIONAL OR MECHANICAL FOOT Conventional foot is of three types : I. Single-Axis Foot II. Double-Axis Foot III. Multi-Axis Foot
SINGLE-AXIS FOOT • The single-axis foot is available for exoskeletal or endoskeletal prostheses. • Its components include a solid wood internal keel, a molded foam rubber shell, a metal single-axis joint, a rubber plantar flexion bumper, and a dorsiflexion stop. • Ankle plantar flexion and dorsiflexion are provided in a limited way by rotation about the ankle joint. Minimal inversion and eversion occur through the flexibility of the rubber sole. Toe dorsiflexion is simulated by the flexibility of the rubber toe section.
SINGLE-AXIS FOOT • The single-axis foot offers shock absorption at heel strike through the plantar flexion bumper, which is available in multiple durometers. Because the foot plantar-flexes after heel strike, thus dampening knee flexion moments, and since it is in contact with the ground for a longer period of time, stance-phase stability is excellent. • Single-axis feet have specific application in transfem-oral (above-knee) prosthetics and are rarely necessary for transtibial amputees, although some amputees prefer the sensation of ankle motion.
ADVANTAGES & DISADVANTAGES OF SINGLE-AXIS FOOT ADVANTAGES • The plantar flexion capability provides increased knee stability at heel strike and foot flat and may lessen the difficulty of descending inclines. • Plantar flexion resistance can be varied DISADVANTAGES • Relatively high maintenance due to moving components. • Increased weight. • Less cosmetic. • Tendency to "squeak."
DOUBLE- AXIS FOOT • Also known as Foreway Foot. • It has medio-lateral ankle joints. • Provides plantarflexion, dorsiflexion, inversion and eversion • It is heavier than Single-Axis Foot • It has two rubber bumper which are added medially and laterally to provide inversion and eversion. • It is not commonly used.
MULTI-AXIS FOOT • This foot provides more ankle motion than any other prosthetic foot. Available for endoskeletal and exoskeletal prostheses, it provides motion in all three planes, which makes it particularly suitable for patients who walk on uneven terrain. • Its components include a solid-wood internal keel, a molded rubber foot, a central rubber rocker block that allows sagittal-plane motion, and a transverse ankle joint that provides inversion, eversion, and transverse rotation. • Joint simulation is achieved by the various bumpers. Although transverse rotation is not truly an anatomic ankle joint motion, it reduces shear forces transmitted to the residual limb and is an alternative to a rotation unit.
MULTI-AXIS FOOT • Shock absorption is excellent in the multiaxis foot because of the many bumpers. The degree of compressibility and rebound of these individual components determines the degree of shock absorption during various gait phases. • Because of the many motions it allows, the foot may be considered less stable statically. However, because of its ability to absorb forces in all planes the multiaxis foot reduces torque on the residual limb that might occur on uneven terrain. • It is a good option for patients who traverse frequently over uneven terrain, but its increased weight and maintenance may overshadow its advantages. It is not recommended for patients who are weak and debilitated, those for which cosmesis is a priority, or those with limited access to prosthetic follow-up.
ADVANTAGES & DISADVANTAGES OF MULTI-AXIS FOOT ADVANTAGES • Allows motion in all planes. • Reduces torque on the residual limb. • Adjustability. DISADVANTAGES • Increased weight. • Increased maintenance. • Decreased cosmesis. • May provide less stability than other feet on smooth surfaces
GREISSINGER FOOT The Greissinger Foot is a multi-axial foot that allows for rotation in all three phases : • Flexion / extension • Inversion / eversion • Internal / external rotation Multi - axis foot - ankle assemblies such as the Greissinger Foot were designed for very active below - knee amputees. They are widely used to reduce the shearing action between the stump and the socket. The Greissinger Foot is characterised by its : • Carbon fibre keel • Polyurethane casing • Multi - axis ankle The advantage of having a multiple degree of freedom axis is that it allows for inversion / eversion that enables the patient to walk on uneven ground.
FLEXIBLE-KEEL DYNAMIC RESPONSE FOOT
FLEXIBLE-KEEL DYNAMIC RESPONSE FOOT Prosthetic feet are primarily designed for walking, yet many lower-limb amputees have the desire to be more active and therefore require the use of a prosthetic foot that will allow them increased activity. This need has promoted research and resulted in a new generation of feet that aid the more active amputee. These feet incorporate a shock absorption mechanism in the form of a flexible keel that dissipates energy, provides a smoother gait, and gives some degree of push-off that the rigid keel cannot provide. As a patient's cadence increases, the amount of time spent on the heel decreases, while the amount of time spent on the forefoot increases. Since relatively more time is spent, and considerably more forces are exerted on the forefoot, there is an increase in the dorsiflexion moment. Through the use of new designs and materials, this dorsiflexion moment allows the keel to compress or distort, thereby absorbing energy that is released during push-off, and aids in propelling the patient forward. Some of the materials currently in use include graphite composite, Delrin, Kevlar, polyurethane elastomer, and flexible rubber, which generally result in a lighter-weight foot. In addition, the feet allow a more fluid motion, which produces a more normal gait.
SPRINGLITE FOOT It is similar in design to the flex foot It consists of carbon & fibre glass filaments surrounded by a short cover.
NON-ARTICULATED SHORT KEEL FEET A non-articulated short-keel design dynamic response foot doesn’t attach to the socket but is attached to a pilon at the ankle. Since, they have shortened keel, they are less responsive and provides less dorsiflexion than the long keel design. Examples : SEATTLE FOOT CC II ( CARBON COPY II ) FOOT QUANTUM FOOT
SEATTLE FOOT It is a Non-Articulated Short-keel foot. It was developed in early 1980s at the University of Washington. This was the first foot to provide increased push-off. It was initially developed for runners and has leaf like appearance and a cleft between great and second-tea that allows bearing beach things. During mid to terminal stance, the keel section gradually stores energy, i.e., released at the end of stance-off.
ADVANTAGES & DISADVANTAGES OF SEATTLE FOOT ADVANTAGES • Dynamic response • Improved cosmetic appearance DISADVANTAGES • Increased weight & cost.
CARBON COPY II FOOT The Carbon Copy II was first introduced on the market in May 1986 by the Ohio Willow Wood Company. It was the most recent entry in the energy storing arena and has only been updated in the past few years. The CC II uses a combination of components from previous designs such as : • Solid ankle. • Kevlar / Nylon keel. • Fibreglass / epoxy attachment plates. • Low density Styrofoam fill. • Heavy polyurethane elastomer outer shell.
FIGURE SHOWING CC II FOOT
CARBON COPY II FOOT The CCII offers, through its design, versatility and can be adapted to many levels of amputation including uni and bi - lateral above and below knee amputees. Overall the CCII is preferred by patients for its light weight and two levels of energy return. The CCII has the ability to provide two levels of energy return. One level is for normal walking were the thin primary deflection plate returns a small amount of energy. The other level of energy return is for rigorous activities were the primary and secondary both act to provide a larger amount of returned energy.
ADVANTAGES & DISADVANTAGES OF CC II FOOT ADVANTAGES Good medio- lateral stability, Light in weight. DISADVANTAGES Costly
FIGURE SHOWING SEATTLE, DYNAMIC, STEN, SAFE & CC II FOOT
QUANTUM FOOT The Quantum, foot was designed and manufactured by Hanger in London and consists of three major components : • The spring module • The foam ankle cosmesis • The foot cosmesis The Quantum foot offers a good range of eversion and inversion as well as rotational control, enabling the patient to walk on inclined surfaces. The foam ankle cosmesis is manufactured from its block form to its desired shape and attached to the foot. The foot cosmesis is a rubber cover for the spring module. Features such as toes and skin colour give it good cosmetic properties.
ARTICULATED DYNAMIC RESPONSE FOOT This foot allows significant terrain accommodation as well as plantarflexion & dorsiflexion, inversion, eversion, torsion, absorption, etc. Example :- True Step.
TRU STEP FOOT Made by the company, named “ College Park”. It was designed to mimic the anatomical foot and ankle. This foot contains cushioning bumpers and ankle alignment bushings. ADVANTAGES  Increased stability & adjustable bumpers. DISADVANTAGES  Increased maintenance,  Expensive,  Available only for adult sizes, low heeled shoes.
ADVANCED PROSTHETIC FOOT PROPRIO FOOT It is also known as Intelligent foot. Manufactured by the company of USA, “ OSSUR “. It provides unprecedented psychological benefits for transtibial amputee. A wide & automated range of ankle fraction with proven flex-foot dynamics means functions as close as you can get today to the human foot. Has stress & strain sensors to determine the scenario of surrounding and receive stimulation.
PROPRIO FOOT This foot “ thinks for itself “ responding beautifully to changing terrain & transforming the approach to stairs and slopes, as well as level ground walking angling itself approximately. Also helps amputees to sit and stand up easily and more naturally Heel height can be changed easily with no impact on alignment of prosthesis. Overall, the effect is a feeling of improved proprioception with more balanced, symmetric and a confident gait with reduced wear & tear on the back, hips and knees. Cutting edge sensors technology & artificial intelligence identifies sloping gradients and ascent & descent of stairs, after the first step and instructs the ankle to flex properly.
PROPRIO FOOT Users can place the foot fully on a step when climbing, descending stairs and it will automatically adopt it’s ankle position to enable the next stop. The active ankle motion also allows users to tuck both feet back behind their knees when getting up from chair or sitting down. Also points the toe down for a more natural appearance once seated, when walking it automatically gives the toe a lift at exact point. In swing phase, that will allow sufficient ground clearance to prevent dragging of foot. Despite it’s sophisticated technology, the proprio foot has an extremely user friendly design and is easy to set up and operate.
BATTERY OF PROPRIO FOOT Simple di-ion battery facilitates 36 hrs of constant use. CHARGING TIME: 3-4 Hrs with 90% discharge at home / on the road. TURN-OFF POWER: When not in use to extend power.
CONCLUSION The human body requires feet in order to provide stability and balance when standing or moving. Amputation of a foot significantly reduces the amputees ability to perform normal activities such as walking. The basic goal of a prosthesis of any type is to improve or restore function to a physically handicapped individual. 1 Prosthetic foot tries to give the normal life to the amputees. Nowadays there are very advanced prosthetic foot which almost behaves like an anatomical foot 2
THANK YOU

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Presentation on prosthetic foot

  • 1.
  • 2.
    CONTENTS INTRODUCTION PURPOSE OF PROSTHETIC FOOT FUNCTIONSOF PROSTHETIC FOOT CLASSIFICATION OF PROSTHETIC FOOT JAIPUR FOOT SACH FOOT & IT’S TYPES SACH FOOT V/S JAIPUR FOOT STEN FOOT MECHANICAL FOOT & IT’S TYPES FLEXIBLE-KEEL DYNAMIC RESPONSE FOOT SPRINGLITE FOOT NON-ARTICULATED SHORT-KEEL FOOT & IT’S TYPES ARTICULATED DYNAMIC RESPONSE FOOT ADVANCED PROSTHETIC FOOT
  • 3.
    INTRODUCTION Current prosthetic footdesigns do not replicate the exact characteristics of a normal foot. A human foot is a multi-functional device that can be used to perform a wide range of activities, however a prosthetic foot is limited to only a few. More recently, manufacturers of prosthetic feet have looked into the characteristics of a prosthesis that may be adjustable. The amputee may then able to perform number of activities without requiring a different prosthesis. Prosthetic foot provide essential connection between prosthesis and ground Currently divided into traditional foot classifications: SACH FLEXIBLE KEEL SINGLE AXIS MULTI AXIS DYNAMIC RESPONSE
  • 4.
    PURPOSE OF PROSTHETIC FOOT The purposeof prosthetic foot is to serve in place of anatomical foot in terms of cosmesis and functions. Cosmesis : prosthetic foot looks like an anatomical foot. Functions like walking , balancing etc.
  • 5.
    FUNCTIONS OF PROSTHETICFOOT Joint simulation : By helping in dorsiflexion & plantarflexion By helping in inversion & eversion Smooth roll over during heel off & toe off. All these movements of prosthetic foot simulates the anatomical foot and thus provides us smooth, more natural and low energy expenditure gait pattern. Shock Absorption: -The foot must absorb the impact of heel strike and weight acceptance without transmitting excessive forces to the residual limb. Too much shock absorption, in contrast, might fail to generate the normal knee flexion when the foot is flat and result in an unacceptable gait pattern. moment A stable weight-bearing base of support Muscle simulation Cosmesis: While function of the prosthetic foot is of primary concern to the prosthetist, the importance of cosmesis cannot be overlooked. The design of a particular foot may enhance or diminish its cosmetic appeal.
  • 6.
    CLASSIFICATION OF PROSTHETIC FOOT PROSTHETIC FOOT CONVENTIONAL FOOT JAIPURFOOT STEN FOOT SAFE FOOT SINGLE AXIS DOUBLE-AXIS MULTI-AXIS SACH FOOT DYNAMIC RESPONSE FOOT NON-ARTICULATED FOOT LONG KEEL NON- ARTICULATED FLEX FOOT SPRINGLITE FOOT SABOLITCH FOOT SHORT KEEL NON- ARTICULATED SEATTLE FOOT CC II FOOT QUANTUM FOOT DYNAMIC FOOT ARTICULATED FOOT TRUSTEP FOOT
  • 7.
    JAIPUR FOOT • TheJaipur Foot, also known as the Jaipur Leg. • It is a rubber-based prosthetic leg for people with below- knee amputations. Although inferior in many ways to the composite carbon fibre variants, its variable applicability and cost efficiency make it an acceptable choice for prosthesis. • Ram Chander Sharma designed and developed it in 1968 • It is a foot piece of same contour (shape) as a human foot with fingers. • It can be used without shoes for base foot walking. • Mostly used by people who belongs to rural background. • It has wide range of motion such as plantarflexion, dorsiflexion, inversion & eversion helps in cross legged position.
  • 8.
    MATERIAL REQUIRED FOR JAIPUR FOOT •Ordinary MCR ( Micro Cellular Rubber ), • Rubber Cord, • Rubber Cushion, • Skin Coloured Rubber, • Dyes, and • Stationary ankle
  • 9.
    ADVANTAGES OF JAIPUR FOOT •It doesn’t require shoes & has certain degree of cosmetic acceptance by amputee. • It permits certain degree of transverse rotation to facilitate gait • Easily available and cheap. • Made up of waterproof material. • Raw materials used for making Jaipur Foot is easily available. • In appearance, it mimics a real foot.
  • 10.
    SACH FOOT It wasfirst manufactured by University of California in 1947. SACH stands for Solid-Ankle Cushion-Heel Feet. Introduced in 1956 by Radcliffe and Foort. The light weight, durability, low cost, and cosmesis of the SACH foot make it the single most frequently recommended prosthetic foot.  Although recent innovations in prosthetic foot design may change this, the SACH foot has been the traditional foot of choice for children and for the majority of adult patients with transtibial or ankle disarticulation amputations. They are available for multiple shoe styles and heel heights, postoperative uses, Syme's fittings, external-keel "waterproof' fittings, and pediatric sizes. The cushioned heel compressed under loading to stimulate ankle plantarflexion and the eccentric contraction of the ankle dorsiflexors during loading response.
  • 11.
    ADVANTAGES & DISADVANTAGES OF SACHFOOT ADVANTAGES Smooth, Durable, Light Weight, Requires little maintenance, Higher degree of acceptance by amputee, and Psychologically accepted by women & children, Good shock absorption for moderately active patients. DISADVANTAGES Lack of ability to absorb the torque produced during locomotion, Limited range of plantarflexion, The heel cushion deteriorates over time, The heel cushion may loose elasticity, The rigid forefoot provides poor shock absorption for high- output activities.
  • 12.
    TYPES OF SACHFOOT SACH FOOT STANDARD SACH FOOT POST-OPERATIVE SACH FOOT SYME SACH FOOT EXTERNAL-KEEL SACH FOOT
  • 13.
    STANDARD SACH FEET Alsoknown as Internel-Keel Sach Foot. Internal-keel SACH feet include a solid wood or aluminum internal keel that extends to the toe break and is surrounded by a molded external foam foot with cosmetic toes and a cushioned heel wedge available in different densities.
  • 14.
    POSTOPERATIVE SACH FOOT Thepostoperative SACH foot is designed so that the patient can walk without shoes or in slippers.  As the name implies, its primary use is on postoperative or temporary prostheses.  It has no heel rise, and since no shoes are worn, the postoperative foot has a wider sole than a standard SACH foot to provide more stability. The molded rubber foot and heel are softer, which makes the postoperative foot very shock absorbent.
  • 15.
    SYME SACH FOOT TheSyme SACH foot was designed to provide the ankle disarticulation amputee with the advantages of a SACH foot. Since an ankle disarticulation in an adult results in only an average I½ in. shortening of the leg, the space available for the addition of a prosthetic foot is limited. The Syme foot, therefore, is lower in height than the SACH foot in order to accommodate this minimal ground clearance. Important to note is the thinner heel cushion. Because the foot height is reduced, the heel cushion is also reduced and therefore less shock absorbent.
  • 16.
    EXTERNAL-KEEL SACH FOOT In theexternal-keel SACH foot the keel portion is not incorporated within the rubber foot. Instead, the rubber portion of the foot is affixed to the keel. It is used for exoskeletal prostheses only. This foot is recommended for a Syme prosthesis when an internal-keel foot will not accommodate a minimal leg length discrepancy. The need for optimum cosmesis at the ankle on an exoskeletal prosthesis may also be an indication for an external-keel SACH foot. The foot's wider keel makes it ideal for patients who require added stability, although an attempt should be made to gain stability through prosthetic alignment first. The external-keel SACH foot also permits the prosthesis to be made waterproof.
  • 17.
    JAIPUR FOOT V/S SACH FOOT SACHFOOT On the basis of appearance SACH foot doesn’t look like a normal foot. SACH foot requires a closed shoe to protect as well as hide it. JAIPUR FOOT On the basis of appearance It looks like a normal foot No such need or requirement with Jaipur Foot. But in case someone wants to wear a shoe, he can do it comfortably with a flat heel shoe.
  • 18.
    JAIPUR FOOT V/S SACH FOOT JAIPURFOOT On the basis of Movements & ADL Cross- legged sitting is possible because sufficient forefoot adduction & transverse rotation of foot in relation to shank is available. Squatting is easily achieved. Bare-Foot walking is possible. As transverse rotation of foot in relation to leg is possible, no complaint of discomfort while walking on uneven ground. SACH FOOT On the basis of Movements & ADL No cross-leg sitting is possible because it requires adduction at forefoot & transverse rotation of foot in relation to shank. Squatting is not possible. Bare-Foot walking is not possible Great discomfort is complained by amputees while walking on uneven surface.
  • 19.
    STEN FOOT The STENfoot is one of the simplest designs in prosthetic feet for it uses the Kingsley foot moulds and rubbers. It comes in a wide variety of sizes and heel heights from a child (18cm keel) through to an adult (30cm keel). The heels also come is soft, medium or hard densities. Although it is slightly heavier than the conventional SACH foot, it differs in its keel which allows for smooth roll - over of the prosthesis. As the name suggests the STEN, STored ENergy, has the capacity to store energy. However, the effectiveness of its ability to store energy is debatable. The structure of its keel disperses the energy rather than storing and then returning it. The STEN Foot is characterised by its : • Varying density heel • Polyurethane bumpers • Reinforcement bands
  • 20.
    ADVANTAGES & DISADVANTAGESOF STEN FOOT ADVANTAGES Allows motion that stimulates to the anatomical foot. It can be accommodated into different shoe types / styles. DISADVANTAGES Expensive Not at all recommended for heavy-weight amputees.
  • 21.
    SAFE FOOT SAFE standsfor STATIONARY ATTACHMENT FLEXIBLE ENDOSKELETAL foot. The SAFE Foot (Stationary Ankle Flexible Endoskeleton) has a solid ankle and provides large amounts of transverse rotation as well as inversion and eversion. The advantage of the SAFE Foot is that it is moisture and grit - resistant. This makes this prosthesis very low maintenance The SAFE foot and other soft keel designs should be viewed as offering increased shock absorption and comfort at the expense of responsiveness in a competitive situation.
  • 22.
    ADVANTAGES & DISADVANTAGES OF SAFEFOOT ADVANTAGES • Little maintenance required, • Moisture resistant, • Adjustable heel height, • Pediatries size available. DISADVANTAGES • Less medio-lateral stability, • Poor push-off at the end of stance phase.
  • 23.
    CONEVNTIONAL OR MECHANICAL FOOT Conventionalfoot is of three types : I. Single-Axis Foot II. Double-Axis Foot III. Multi-Axis Foot
  • 24.
    SINGLE-AXIS FOOT • Thesingle-axis foot is available for exoskeletal or endoskeletal prostheses. • Its components include a solid wood internal keel, a molded foam rubber shell, a metal single-axis joint, a rubber plantar flexion bumper, and a dorsiflexion stop. • Ankle plantar flexion and dorsiflexion are provided in a limited way by rotation about the ankle joint. Minimal inversion and eversion occur through the flexibility of the rubber sole. Toe dorsiflexion is simulated by the flexibility of the rubber toe section.
  • 25.
    SINGLE-AXIS FOOT • Thesingle-axis foot offers shock absorption at heel strike through the plantar flexion bumper, which is available in multiple durometers. Because the foot plantar-flexes after heel strike, thus dampening knee flexion moments, and since it is in contact with the ground for a longer period of time, stance-phase stability is excellent. • Single-axis feet have specific application in transfem-oral (above-knee) prosthetics and are rarely necessary for transtibial amputees, although some amputees prefer the sensation of ankle motion.
  • 26.
    ADVANTAGES & DISADVANTAGES OF SINGLE-AXISFOOT ADVANTAGES • The plantar flexion capability provides increased knee stability at heel strike and foot flat and may lessen the difficulty of descending inclines. • Plantar flexion resistance can be varied DISADVANTAGES • Relatively high maintenance due to moving components. • Increased weight. • Less cosmetic. • Tendency to "squeak."
  • 27.
    DOUBLE- AXIS FOOT •Also known as Foreway Foot. • It has medio-lateral ankle joints. • Provides plantarflexion, dorsiflexion, inversion and eversion • It is heavier than Single-Axis Foot • It has two rubber bumper which are added medially and laterally to provide inversion and eversion. • It is not commonly used.
  • 28.
    MULTI-AXIS FOOT • Thisfoot provides more ankle motion than any other prosthetic foot. Available for endoskeletal and exoskeletal prostheses, it provides motion in all three planes, which makes it particularly suitable for patients who walk on uneven terrain. • Its components include a solid-wood internal keel, a molded rubber foot, a central rubber rocker block that allows sagittal-plane motion, and a transverse ankle joint that provides inversion, eversion, and transverse rotation. • Joint simulation is achieved by the various bumpers. Although transverse rotation is not truly an anatomic ankle joint motion, it reduces shear forces transmitted to the residual limb and is an alternative to a rotation unit.
  • 29.
    MULTI-AXIS FOOT • Shockabsorption is excellent in the multiaxis foot because of the many bumpers. The degree of compressibility and rebound of these individual components determines the degree of shock absorption during various gait phases. • Because of the many motions it allows, the foot may be considered less stable statically. However, because of its ability to absorb forces in all planes the multiaxis foot reduces torque on the residual limb that might occur on uneven terrain. • It is a good option for patients who traverse frequently over uneven terrain, but its increased weight and maintenance may overshadow its advantages. It is not recommended for patients who are weak and debilitated, those for which cosmesis is a priority, or those with limited access to prosthetic follow-up.
  • 30.
    ADVANTAGES & DISADVANTAGES OF MULTI-AXIS FOOT ADVANTAGES •Allows motion in all planes. • Reduces torque on the residual limb. • Adjustability. DISADVANTAGES • Increased weight. • Increased maintenance. • Decreased cosmesis. • May provide less stability than other feet on smooth surfaces
  • 31.
    GREISSINGER FOOT The GreissingerFoot is a multi-axial foot that allows for rotation in all three phases : • Flexion / extension • Inversion / eversion • Internal / external rotation Multi - axis foot - ankle assemblies such as the Greissinger Foot were designed for very active below - knee amputees. They are widely used to reduce the shearing action between the stump and the socket. The Greissinger Foot is characterised by its : • Carbon fibre keel • Polyurethane casing • Multi - axis ankle The advantage of having a multiple degree of freedom axis is that it allows for inversion / eversion that enables the patient to walk on uneven ground.
  • 32.
  • 33.
    FLEXIBLE-KEEL DYNAMIC RESPONSEFOOT Prosthetic feet are primarily designed for walking, yet many lower-limb amputees have the desire to be more active and therefore require the use of a prosthetic foot that will allow them increased activity. This need has promoted research and resulted in a new generation of feet that aid the more active amputee. These feet incorporate a shock absorption mechanism in the form of a flexible keel that dissipates energy, provides a smoother gait, and gives some degree of push-off that the rigid keel cannot provide. As a patient's cadence increases, the amount of time spent on the heel decreases, while the amount of time spent on the forefoot increases. Since relatively more time is spent, and considerably more forces are exerted on the forefoot, there is an increase in the dorsiflexion moment. Through the use of new designs and materials, this dorsiflexion moment allows the keel to compress or distort, thereby absorbing energy that is released during push-off, and aids in propelling the patient forward. Some of the materials currently in use include graphite composite, Delrin, Kevlar, polyurethane elastomer, and flexible rubber, which generally result in a lighter-weight foot. In addition, the feet allow a more fluid motion, which produces a more normal gait.
  • 34.
    SPRINGLITE FOOT It issimilar in design to the flex foot It consists of carbon & fibre glass filaments surrounded by a short cover.
  • 35.
    NON-ARTICULATED SHORT KEELFEET A non-articulated short-keel design dynamic response foot doesn’t attach to the socket but is attached to a pilon at the ankle. Since, they have shortened keel, they are less responsive and provides less dorsiflexion than the long keel design. Examples : SEATTLE FOOT CC II ( CARBON COPY II ) FOOT QUANTUM FOOT
  • 36.
    SEATTLE FOOT It isa Non-Articulated Short-keel foot. It was developed in early 1980s at the University of Washington. This was the first foot to provide increased push-off. It was initially developed for runners and has leaf like appearance and a cleft between great and second-tea that allows bearing beach things. During mid to terminal stance, the keel section gradually stores energy, i.e., released at the end of stance-off.
  • 37.
    ADVANTAGES & DISADVANTAGESOF SEATTLE FOOT ADVANTAGES • Dynamic response • Improved cosmetic appearance DISADVANTAGES • Increased weight & cost.
  • 38.
    CARBON COPY IIFOOT The Carbon Copy II was first introduced on the market in May 1986 by the Ohio Willow Wood Company. It was the most recent entry in the energy storing arena and has only been updated in the past few years. The CC II uses a combination of components from previous designs such as : • Solid ankle. • Kevlar / Nylon keel. • Fibreglass / epoxy attachment plates. • Low density Styrofoam fill. • Heavy polyurethane elastomer outer shell.
  • 39.
  • 40.
    CARBON COPY IIFOOT The CCII offers, through its design, versatility and can be adapted to many levels of amputation including uni and bi - lateral above and below knee amputees. Overall the CCII is preferred by patients for its light weight and two levels of energy return. The CCII has the ability to provide two levels of energy return. One level is for normal walking were the thin primary deflection plate returns a small amount of energy. The other level of energy return is for rigorous activities were the primary and secondary both act to provide a larger amount of returned energy.
  • 41.
    ADVANTAGES & DISADVANTAGESOF CC II FOOT ADVANTAGES Good medio- lateral stability, Light in weight. DISADVANTAGES Costly
  • 42.
  • 43.
    QUANTUM FOOT The Quantum,foot was designed and manufactured by Hanger in London and consists of three major components : • The spring module • The foam ankle cosmesis • The foot cosmesis The Quantum foot offers a good range of eversion and inversion as well as rotational control, enabling the patient to walk on inclined surfaces. The foam ankle cosmesis is manufactured from its block form to its desired shape and attached to the foot. The foot cosmesis is a rubber cover for the spring module. Features such as toes and skin colour give it good cosmetic properties.
  • 44.
    ARTICULATED DYNAMIC RESPONSE FOOT Thisfoot allows significant terrain accommodation as well as plantarflexion & dorsiflexion, inversion, eversion, torsion, absorption, etc. Example :- True Step.
  • 45.
    TRU STEP FOOT Madeby the company, named “ College Park”. It was designed to mimic the anatomical foot and ankle. This foot contains cushioning bumpers and ankle alignment bushings. ADVANTAGES  Increased stability & adjustable bumpers. DISADVANTAGES  Increased maintenance,  Expensive,  Available only for adult sizes, low heeled shoes.
  • 46.
    ADVANCED PROSTHETIC FOOT PROPRIOFOOT It is also known as Intelligent foot. Manufactured by the company of USA, “ OSSUR “. It provides unprecedented psychological benefits for transtibial amputee. A wide & automated range of ankle fraction with proven flex-foot dynamics means functions as close as you can get today to the human foot. Has stress & strain sensors to determine the scenario of surrounding and receive stimulation.
  • 47.
    PROPRIO FOOT This foot“ thinks for itself “ responding beautifully to changing terrain & transforming the approach to stairs and slopes, as well as level ground walking angling itself approximately. Also helps amputees to sit and stand up easily and more naturally Heel height can be changed easily with no impact on alignment of prosthesis. Overall, the effect is a feeling of improved proprioception with more balanced, symmetric and a confident gait with reduced wear & tear on the back, hips and knees. Cutting edge sensors technology & artificial intelligence identifies sloping gradients and ascent & descent of stairs, after the first step and instructs the ankle to flex properly.
  • 48.
    PROPRIO FOOT Users canplace the foot fully on a step when climbing, descending stairs and it will automatically adopt it’s ankle position to enable the next stop. The active ankle motion also allows users to tuck both feet back behind their knees when getting up from chair or sitting down. Also points the toe down for a more natural appearance once seated, when walking it automatically gives the toe a lift at exact point. In swing phase, that will allow sufficient ground clearance to prevent dragging of foot. Despite it’s sophisticated technology, the proprio foot has an extremely user friendly design and is easy to set up and operate.
  • 49.
    BATTERY OF PROPRIO FOOT Simpledi-ion battery facilitates 36 hrs of constant use. CHARGING TIME: 3-4 Hrs with 90% discharge at home / on the road. TURN-OFF POWER: When not in use to extend power.
  • 50.
    CONCLUSION The human bodyrequires feet in order to provide stability and balance when standing or moving. Amputation of a foot significantly reduces the amputees ability to perform normal activities such as walking. The basic goal of a prosthesis of any type is to improve or restore function to a physically handicapped individual. 1 Prosthetic foot tries to give the normal life to the amputees. Nowadays there are very advanced prosthetic foot which almost behaves like an anatomical foot 2
  • 51.