Choosing the best prosthetic foot is a personal journey. A prosthetic foot replaces a missing foot, helping you walk and move.
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The ideal choice depends on your daily activities, mobility, and personal goals. This guide will help you understand what to consider, the types available, and how to make the best choice for your lifestyle.
Prosthetic feet are more than just a functional replacement for a lost human foot. They are a key to unlocking new potentials, reaching new heights, and conquering new challenges.
Choosing a prosthetic foot isn’t just about walking again. It’s about living the way you want to. That choice depends on your body, your routine, and what feels right for you.
The level of amputation is a significant factor that directly influences the type of prosthetic foot that would best serve your needs.
If you’ve had a partial foot amputation like losing your toes or the front of your foot, you’ll need support that matches your remaining structure.
If you’ve had a below-knee amputation, your natural knee joint is intact. In this case, your prosthetist will look at factors like the length of your residual limb, its strength and range of motion to recommend a suitable foot.
For above-knee amputations, a prosthetic knee joint is necessary and its type will help you choose the suitable prosthetic foot.
Your prosthetist will assess how the knee joint functions and then suggest a foot that complements it.
How active are you? Do you enjoy a morning jog or prefer a leisurely stroll in the park? Your response to these questions influences the decision-making process for the right prosthetic foot.
Prosthetic feet are built to match how much you move. For lower activity levels like walking indoors or on flat ground, the goal is to keep you stable and balanced. So simpler feet like a single-axis model may be enough.
If you’re more active, your foot should absorb shock at heel strike, adapt to uneven ground, roll smoothly from heel to toe, and help push you forward as you step. A multiaxial or energy-storing foot could give you the flexibility and bounce you need.
Materials also change depending on how active you are. Prosthetic feet made with wood, foam, or plastic usually offer more stability like an anatomical foot and work well for lower activity levels.
If you’re more active, carbon fiber prosthetics is common and ideal. It’s lighter and built to absorb shock and return energy with each step.
Some prosthetic feet have a spring in the heel and forefoot, making them ideal for walking at different speeds, running, or climbing stairs with confidence.
The longer the carbon fiber spring, the more energy it stores, making the foot even more responsive.
Selection of a prosthetic foot is more than just a medical decision – it’s a lifestyle choice. Age, weight, foot size, and lifestyle—all of this matters.
These factors help determine the level of durability and functionality required for your daily activities and overall quality of life.
A teenager and a retiree will have different needs, even with the same amputation level. So it helps to look at your habits and goals before choosing.
Ask yourself:
These questions might help you select the prosthetic foot that will complement and function well in your unique circumstances.
When selecting a prosthetic foot, consider these factors:
You don’t have to figure it out alone. A prosthetist can help you test different options and explain how they work. Just remember, your foot, your life. Make sure it fits both.
Understanding the different types of prosthetic feet can help you choose the right one for your needs.
The SACH foot is a basic and non-moving prosthetic foot with a cushioned heel that helps absorb shock during walking.
It provides single-axis motion that mimics the natural movement of your foot, making it ideal if you have lower activity levels who prioritize stability and support.
One standout option is the Ottobock SACH+ Foot, designed especially for seniors or those with low mobility.
Instead of the traditional wooden core, the SACH+ Foot uses a fiberglass-reinforced plastic core combined with durable functional foam.
This makes it stronger, more water-resistant, and better for everyday use. It also gives you a stable and safe step when your heel touches the ground.
It comes in both standard and narrow foot shapes, with natural-looking toes and a smooth surface that blends in during daily activities.
Your prosthetist can help match the right model to your foot size and body weight, ensuring comfort and confidence with every step.
A Single-Axis foot moves up and down to improve stability, especially on slopes or uneven ground. It helps enhance knee stability, making it a good option if you have knee or hip challenges.
Though it may need more maintenance due to moving parts, the added control can be worth it.
WillowWood offers one of the most advanced designs in this category. Their Single Axis Foot is made from strong and lightweight composites, making it up to 20% lighter than traditional versions.
It includes a molded-in titanium pyramid, a water-resistant unisex foot shell, and interchangeable bumpers with different resistance levels.
You can get it as a standalone foot or as part of a full assembly with the ankle and bumpers included.
A multi-axial foot moves in different directions, making it easier to walk on uneven ground. It helps absorb impact and reduces stress on your residual limb, which is great if you’re active and need more balance and comfort.
The Triton Side Flex by Ottobock is a strong example of this design. It’s made for highly active users who move between different indoor and outdoor surfaces and want reliable response and control, even during high-impact movements.
This foot offers side-to-side flexibility and solid ground contact, helping you stay steady on slopes or rough terrain.
By reducing the strain on your knee and socket, it lets you move more naturally and focus on your day—not your steps.
It gives you smooth rollover, high energy return, and the support to stay agile in motion.
For many, it's more than a foot—it's the base that brings freedom back.
This type of foot stores and releases energy as you walk, helping you move with a more natural and efficient stride.
They’re often made with lightweight, durable carbon fiber that absorbs energy when your foot presses down and releases it during push-off.
Great for those with moderate to high activity levels as it offers more flexibility and support for different walking speeds and terrains.
The Fillauer Ibex XD is a great example. It uses micro-slice technology in the pylon and a split heel plate to control side-to-side motion on uneven ground.
Its long carbon pylon and full-length heel plate help it reach foot-flat faster, storing more energy without sacrificing stability.
From heel strike to toe-off, every part of the foot works together to give you both balance and power. An adjustable heel wedge also lets you fine-tune the stiffness to match your comfort and activity needs.
It’s a tough and high-performing option for heavier users who need solid energy return and the confidence to keep moving..
Microprocessor feet use built-in sensors to adjust the ankle’s position in real time, based on how fast you're walking and the surface you're on.
They help you move more smoothly across ramps, stairs, and uneven ground by offering a personalized walking experience.
While they need charging and tend to be more expensive, the stability and comfort they offer make a big difference—especially for active users.
The Össur Proprio Foot is a great example of this technology. It’s built for low to moderately active users and focuses on safety by raising the toe during swing phase, reducing the chance of tripping.
It automatically adapts to changes in terrain like slopes and stairs, making each step more stable.
The dynamic carbon foot blade gives it a smooth roll-over, while special modes make sitting and standing more comfortable.
It’s waterproof in both salt and fresh water and comes with an app that helps with setup, tracking steps, adjusting ankle position, and checking the battery.
Proprio Foot gives you the freedom to move more naturally, with more confidence in every step.
Battery-powered prosthetic feet help mimic the movement of your natural foot and ankle. They provide extra push at toe-off, reduce joint strain, and make walking more comfortable and stable.
While they offer great benefits like improved walking, they do come with some challenges, such as added weight, maintenance, and the need for regular charging.
The Ottobock Empower prosthetic foot is made for active users who move between indoor and outdoor spaces. It’s perfect if you walk longer distances and at higher speeds.
It helps mimic muscle function by providing powered push-off and extra comfort during rollover, especially on slopes.
The battery lasts up to eight hours, depending on how much you use it, and can be charged in under 90 minutes with a dual charger. The battery level is easy to monitor, so you’re always in control.
If you want both mobility and durability, the Empower foot is more than just a prosthetic—it's a foundation for an active lifestyle.
Hydraulic prosthetic feet adjust resistance based on your movements, offering better stability and comfort on surfaces like ramps and stairs. They’re ideal if you have higher mobility needs, especially if you're active.
The Blatchford Echelon is a great example. It has a waterproof hydraulic ankle that absorbs impact, adjusts to rough surfaces, and stays flexed at toe-off.
This design reduces pressure on the prosthetic socket and joints, improving comfort, posture, and lowering the risk of falls.
Tailored for specific activities like running, swimming, or hiking, these feet enhance performance for particular sports or hobbies, offering specialized support for various motions and environments.
The Össur Flex-Foot Cheetah is a high-performance carbon fiber foot designed for sprinting, trusted by athletes since .
It delivers excellent energy return with performance adjusted to your weight and impact, ideal for long distance runners. It is also waterproof, offering protection in fresh, salt, and chlorinated water.
Your activity level plays a major role in choosing the right prosthetic foot.
To guide this process, mobility levels are classified by K Levels:
K-Levels are used to indicate rehabilitation potential and assess how effectively you can use a prosthetic device.
Understanding your K-Level helps determine which prosthetic foot fits your lifestyle and needs.
When selecting a prosthetic foot, consider discussing:
When selecting a prosthetic foot, it’s important to discuss these things to ensure you get the best fit and comfort for your lifestyle.
Your prosthetist can guide you through the process, helping you choose the right foot, make necessary adjustments, and test different options during trial periods.
Additionally, understanding your insurance coverage and any costs will help you make informed decisions about your prosthetic care.
A prosthesis can cost anywhere between $3,000 and more than $100,000, depending on the extent of the prosthetic. Be sure to check with your insurance company before making any decisions.
The most common prosthetic foot is the SACH foot, which is basic, low-cost, and includes a solid ankle and rigid keel. Consider this option for a simple and affordable prosthetic foot.
Typically, prosthetic foot lasts 3-5 years, but this varies based on usage and care.
It's generally not recommended to use one prosthetic foot for all activities, as activities require different levels of support. Your prosthetist will help you select the best foot based on your needs and activity level.
1. Introduction
The solid ankle cushion heel, or SACH foot has proved to be a valuable component for lower-extremity prostheses; it can be used with all prostheses that require a full artificial foot. There is significantly less irritation of the amputation stump with use of the SACH foot, especially in below-the-knee amputees, because of the diminished torsion upon the stump and less jarring from heel impact. The degree of comfort for the amputee using an artificial lower limb with a SACH foot is increased as a result of the cushioned heel and smooth rocker action.
SACH Foot has a wooden keel which is long enough to restrict/limit movements in all directions and whatsoever movements take place, they occur at unnatural sites.
The SACH prosthetic design has many variations, but they are all based on a similar concept. A SACH foot is generally used when mid-stance stability is desired for the user [1]. The SACH foot has been considered the standard prosthetic foot prescribed to those with low function and activity levels. The SACH foot was the first prosthetic foot to exhibit roll-over shape [2]. The minimal parts allow for easier use and maintainability. The SACH foot is available at low cost because of the minimal parts needed and is the most prescribed prosthetic foot [1].
Several shortcomings of the SACH foot have been discovered in clinical trials and in human subject testing. A study completed at Northwestern indicated that the SACH foot often exhibits shortcomings in plantar flexion due to its rigid design [3]. This aspect of the foot also plays into its success because the rigidity in turn offers stability in the early phases of the gait cycle. The SACH foot also had issues with low energy return when compared to the Flex Foot [3]. It has also been found that the SACH foot has a shorter roll-over shape than a human foot and other prosthetic feet, such as the SR, which means that, at the toe region it is not as able to support weight [4].
2. Methodology
2.1. Research Design
The research design used for the purpose of this work was an experimental design which helped to compare both the locally fabricated SACH foot and the foreign SACH foot in terms of patient satisfaction and energy expenditure while using both feet.
The data were analyzed using various statistical means including; mean, standard deviation and Paired T-test.
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2.2. Research Survey
This study adopted the survey research design. Survey design was explained by [5] as a procedure used in obtaining information from a sample or relevant population that is familiar with the ideas relating to the objectives of the study. In the opinion of [6] survey design is one which studies large or small population by selecting and analyzing (sample) data collected from the group through the use of questionnaire, or personal interview. The design is therefore appropriate for this study as it was used to obtain data from patients who have had amputation and are currently using a prosthetic lower limb in Port Harcourt.
2.3. Area of Study
The area of study is Port Harcourt; Port Harcourt is the capital city of Rivers State and a metropolitan city which is the fifth-largest city in Nigeria after Lagos, Kano, Ibadan and Benin City. It lies along the Bonny River and is located in the Niger Delta. As at , the Port Harcourt urban area has an estimated population of 1,865,000 inhabitants, up from 1,382,592 as at [7].
Port Harcourt is a major industrial centre as it has a large number of multinational firms as well as other industrial concerns, particularly business related to the petroleum industry. It is the chief oil-refining city in Nigeria and has two main oil refineries located at Eleme. Rivers State is one of the wealthiest states in Nigeria in terms of gross domestic product and foreign exchange revenue from the oil industry, crude oil being its principal export earner [8].
Amputees from this part of the state prefer using prosthesis for daily activities so as to fit back into the society.
2.4. Research Instrument
The instrument for data collection was a structured questionnaire, which contains 25 items in all. These items were divided into four sections encompassing the four important research questions necessary for the study.
Patient Satisfaction Survey was employed for the purpose of this study to offer tested questions for measuring patient satisfaction individually after the use of both prosthetic foot (Locally fabricated SACH foot and foreign SACH foot). Users’ satisfaction with the prosthesis was assessed by means of the prosthesis evaluation questionnaire (PEQ). The questionnaire consists of a series of items with a linear analogical scale response format, organized into six functional domain scales, widely used to analyze the impact and response on TTAs with the two different prosthetic feet (the local SACH foot and foreign SACH feet). The functional scales are: ambulation, size, appearance, comfort, change in heart beat, and wellbeing. The reliability and validity of this survey have previously been assessed.
2.5. Materials and Tools
2.5.1. Materials for Fabrication
・ Core wood
・ Ethylene vinyl acetate ( rubber foam)
・ Flexible tyre
・ Gum
・ Cooper nails
・ Cosmetic leather
・ Sand paper
2.5.2. Tools for Fabrication
・ Grinding machine/filing machine
・ Jig saw
・ Drilling machine
・ Hammer
・ Scissors
・ Bench vice
・ Heating gun
・ Handsaw
・ Goniometer
・ Chisel
・ Hand file
・ Meter rule
・ Measuring tape
・ Cardboard sheet
2.6. Method of Fabrication
・ The impression of the foot to be fabricated was taken on a cardboard sheet and then it was divided into three (the hind, mid and fore foot). As shown in Figure 1.
・ A core wood of length 26 cm and width 8 cm was cut out.
・ 45˚ was measured using a goniometer at the hind foot part of wood which served as the heel of the foot.
・ 15˚ was measured at the mid foot part, this degree gives the slope of the mid foot to the fore foot.
・ 7˚ from the fore part of the wood to the plantar aspect was measured; this gives the toe clearance of the foot.
・ With the aid of the hand saw, the measured and marked portions were chopped out and grinded using the grinding machine.
・ The hand file was used to reduce size of the work piece and ensure all curves were visible before using the grinding machine to smoothen the work piece (foot).
・ The drilling machine was also used to bore hole at the intersection point of the midline of the foot and the marked line which differentiated the hind and mid foot.
・ At the plantar surface of the foot, a spiral drill bit was incorporated into the drilling machine and was used to bore a wide hole that was used as the locking device.
・ Elastic rubber padded in ten layers was glued together and cut in a slant form and was used to form the heel of the foot.
・ Appropriate smoothening was done round the foot as shown in Figure 2.
・ A layer of thick ethylene vinyl acetate (EVA) form was heated in an industrial oven and then wrapped around the work piece to give it a cosmetic finishing as shown in Figure 3.
2.7. Tools/Instrument for Data Collection
・ Automated sphygmomanometer
・ Thermometer
・ Marker
・ Black trampoline
・ Powdered chalk/white powder
・ Measuring tape
・ Stopwatch
・ Pen and paper
・ Questionnaire
2.8. Inclusion and Exclusion Criteria
・ Patients resident in Rivers State were included in the survey; for easy access.
・ Patients’ having unilateral transtibial amputation that has used prosthesis before were included; to avoid fall and other arising problems as a result of the use of the prosthesis.
・ Patients without known peripheral vascular disease, whose skin is free from abrasion and blisters which may interfere with gait pattern were included.
・ Patients with known gait and cardiovascular abnormalities were excluded from participation.
・ Patients with bilateral lower limb amputation were also excluded.
・ Patients who are using the wheelchair and other assess instruments were not allowed to participate in the study.
2.9. Materials/Instruments
・ White Paint
・ Measuring tape
・ Polyethylene
・ Rag
・ Record book and pen
・ Stop watch
・ Walking lawn
・ Omron Automatic Blood Pressure Monitor (Model HEM-)
2.10. Procedure
・ Participants’ cardiovascular response was measured before the start of the process.
・ A 12" horizontal line was measured using a measuring tape and points were marked.
・ The centre of the horizontal line at the 6" mark was marked and a vertical line of 240" was measured which gave the line of progression (i.e. the patients direction during data collection).
・ Participant wore both SACH foots (locally fabricated foot and foreign SACH foot) at interval with a polyethylene and their feet were immersed into a white paint.
・ Participant stood at their comfortable position and their base of support was measured.
・ Participant was asked to walk a distance of 240" and the stop watch was used to record the corresponding time spent.
・ Time taken in seconds was recorded and the gait parameters were recorded by measuring the foot prints of the participants.
・ Participants’ cardiovascular response was measured at the end of the process.
・ The above processes were repeated for other participants.
3. Discussion
To design a good, functional, efficient and safe substitute to a foreign foot using locally sourced materials, it is important to study the effects of different SACH foot on a specific category of amputees.
This research work fills an important gap in the literature as, to the best of my knowledge; there are no similar studies about the considered prosthetic feet for low-activity users with so wide, a range of clinical evaluations.
4. Result
After the replacement of the foreign SACH foot with a locally fabricated SACH foot, patients have maintained the same level of stability and perceived safety, while presenting a significant albeit slight improvement in some important clinical aspects such as, the weight and overall mobility, balance, general comfort, and the perceived satisfaction with their own prosthesis.
5. Conclusions
The findings demonstrate that a locally fabricated SACH foot represents an alternative solution with respect to the foreign SACH foot in the prescription of prosthetic foot for hypomobile TTAs.
Thus, the range of prosthetic devices available to practitioners involved in amputee rehabilitation is increased, therefore allowing them to select the most appropriate solution for each specific subject based on their clinical experience and patient financial status.
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