What is the best prosthetic foot for walking?

For the amputee, there is a wide range of prosthetic foot selections to accommodate almost every lifestyle.

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As with other prosthetic componentry, advancing technology has expanded choices in the prosthetic foot &#; from the basic SACH (solid ankle cushion heel) foot for walking to energy-storing feet for higher activity levels to microprocessor-controlled feet, which use advanced computer-controlled sensors that process information from both the individual&#;s limb and the surrounding environment to adjust to various needs.

While there is a prosthetic foot for seemingly every amputee, budgetary considerations sometimes come into play. Costs and insurance coverage can vary depending on the type of prosthesis and its function level. Medicare uses a system called K-levels to determine whether it will pay for a specific prosthetic foot, knee, or even shock absorber.

K-Levels are broken into four categories that characterize a lifestyle or potential functional level. When a patient is a new amputee, he may be functioning at a low level as he adjusts to his new condition; but if that person led an active lifestyle pre-amputation, there is every expectation that he can return to his previous activity level within a reasonable period of time. A patient knowing his or her K-Level classification can help to explain why a particular foot component is the right choice for that individual.

Designing prosthetic foot systems is challenging. It&#;s very difficult to reproduce the complex workings of the human foot and ankle. Ideally the foot will be light because its weight is added to the rest of the prosthetic leg. If the foot is too heavy and the suspension of the prosthesis is not appropriate, the connection to the socket and your limb will be affected and also the overall function of the prosthesis.

A good prosthetic foot should also be strong, as it will be taking on large forces and torque as you walk and run. Feet must also be small enough to fit within a foot shell, a cosmetic covering for the prosthetic foot, and thus fit within a shoe. Being light, strong and small whilst still remaining functional and durable is the challenge.

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Early designs for prosthetic feet were often a solid piece of wood. A similar design, the SACH (solid-ankle-cushioned-heel) is still in use because of its sturdy function. It is especially useful for individuals with lower activity levels. A SACH foot typically has a rigid inner structure (wood or plastic) surrounded by a compressible foam cosmetic shell.

Today&#;s more sophisticated feet add more functions and are secured inside a cosmetic shell. Most people never see their prosthetic foot without this exterior shell. The cosmetic shell stretches around the prosthetic foot and serves two purposes:

• It makes your prosthetic foot look like an anatomical foot.

• It fits snuggly in your shoe.

What&#;s inside the shell can vary dramatically. Prosthetic feet are designed to meet the needs of your lifestyle and activity level. Here are some factors to consider.

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