Segmental contributions to sagittal-plane whole-body angular momentum when using powered compared to passive ankle-foot prostheses on ramps

Understanding the effects of an assistive device on dynamic balance is crucial, particularly for robotic leg prostheses. Analyses of dynamic balance commonly evaluate the range of whole-body angular momentum (H). However, the contributions of individual body segments to overall H throughout gait may yield futher insights, specifically for people with transtibial amputation using powered prostheses. We evaluated segment contributions to H using Statistical Parametric Mapping to assess the effects of prosthesis type (powered vs passive) and ramp angle on segmental coordination. The slope main effect was significant in all segments, the prosthesis main effect was significant in the prosthetic leg (device and residuum) and trunk, and the slope by prosthesis interaction effect was significant in the prosthetic leg and trunk. The magnitude of contributions to sagittal-plane H from the prosthetic leg was larger when using the powered prosthesis. The trunk contributed more positive (backward) H after prosthetic leg toe-off when using the powered prosthesis on inclines, similar to the soleus muscle. However, trunk contributions to H on declines were similar when using a powered and passive prosthesis, suggesting that the powered prosthesis may not replicate soleus function when walking downhill. Our novel assessment method evaluated robotic leg prostheses not only based on local joint mechanics, but also considering whole-body biomechanics.