Significance of non-level walking on transtibial prosthesis fitting with particular reference to the effects of anterior-posterior alignment

Despite the fact that non-level walking is known to be important for prosth esis fitting, its clinical significance has not been investigated. In this study, the acceptable prosthesis alignment ranges of six subjects with tran stibial amputation on level and non-level walking were determined and compa red. With the aid of a recently developed alignment jig, prosthesis fitting was performed for each subject with varied anterior-posterior (AP) alignme nts. Conventional assessments and the subjects' comment were used to determ ine whether the alignment was acceptable or not. The results showed that th e acceptable alignment range for non-level walking consistently fell within and was significantly smaller than that for level walking with p<0.05. It was evident that non-level walking is important for better approximation of optimum alignment and should be included in routine prosthesis fitting.