Prolonged adaptation to a robotic prosthesis enhances gait symmetry: A case study in a transtibial amputee

초록

Purpose: This study evaluates the long-term biomechanical and energy efficiency effects of a high-torque, lightweight robotic ankle-foot prosthesis (RAF Pro) in a transtibial amputee, focusing on its potential to enhance gait symmetry and functionality. Methods: A six-month longitudinal case study was conducted on a 51-year-old male transtibial amputee transitioning from a passive prosthesis to the RAF Pro. Comprehensive gait analyses, including motion capture and force plate assessments, were performed at four intervals: initial fitting, three months, four and a half months, and six months. The participant received continuous, tailored rehabilitation training throughout the study. Results: Over the adaptation period, notable improvements were observed in plantarfiexion during toe-off and in the coordination of hip and knee joint movements, contributing to enhanced gait symmetry. By the six-month mark, the subject achieved near-symmetrical gait mechanics with significantly reduced energy expenditure during walking, approaching the biomechanical efficiency observed in non-amputees. Conclusion: This case study highlights the potential of long-term adaptive rehabilitation combined with advanced robotic prostheses to restore natural, energy-efficient gait mechanics in transtibial amputees. The findings emphasize the importance of a minimum six-month adaptation period for optimizing prosthetic function, offering valuable insights for personalized rehabilitation strategies and future prosthetic development. (c) 2025 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

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