Feet and Ankles
For the amputee, there is a wide range of feet selection to accommodate almost every lifestyle.
As with other prosthetic componentry, advancing technology has expanded choices in prosthetic feet – 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.
K1: This is typical of a household ambulator or a person who only walks about in their own home.
K2: The amputee has the ability or potential for ambulation with the ability to traverse low-level environmental barriers such as curbs, stairs or uneven surfaces. This is typical of the limited community ambulator.
K3: The patient has the ability or potential for ambulation with variable cadence and has the ability to cross over most environmental barriers or who may have vocational, therapeutic, or exercise activity that demands prosthetic use beyond simple walking.
K4: The patient has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. This is typical of the prosthetic demands of the child, active adult, or athlete.
Your prosthetist will help you make the right foot selection based on your health, height and weight, level of amputation and the length and shape of the residual limb as well as your mobility goals.
Here are many of the options we offer at Leimkuehler Orthotic-Prosthetic Center.
Based on information from input signals, microprocessors apply an algorithm, or set of rules, to make decisions about how the ankle or foot should respond in any given situation. Adjustments are made in real-time based on walking speed, incline, decline and type of terrain.
Blatchford Elan mimics natural muscle resistance and ankle motion by adapting hydraulic resistance levels to optimize stability when standing and walking on slopes and uneven terrain. This encourages more symmetrical limb loading, faster walking speed and reduced compensatory movements. The ankle pivot point is optimally positioned close to the natural weight line for a more natural response through the gait cycle. The result is smoother, safer and more natural walking, helping to preserve the body for the long term.
Freedom Innovations Kinnex2 integrates microprocessor ankle/foot technology and carbon fiber to provide low to moderate impact K3 ambulators the stability they expect – instantly. Unmatched ground compliance, improved comfort, and automated heel height adjustments keep users firmly grounded and connected, wet or dry. Kinnex allows the prosthetic user to navigate environmental obstacles such as ramps, slopes, uneven terrain, and stairs with added confidence and stability. Other benefits include reduced internal socket pressures and improved comfort when sitting, squatting or standing.
The Ottobock Meridium offers a high level of safety along with increased adaptability and a more natural motion sequence. Incorporating intelligent, real-time control, the 4-axis design adjusts itself immediately to the user’s walking speed and ground conditions, whether on slopes, stairs or varying terrain. The relief function automatically lowers the forefoot to the floor when sitting, providing a comfortable, more natural foot position. With its automatic heel height adjustment, the Meridium is suitable for various types of shoes.
Össur’s Proprio incorporates a carbon fiber foot with a microprocessor controlled hydraulic ankle unit. Sensors in the Proprio foot determine the direction and speed of the foot movement. The microprocessor then controls the angle of the ankle during swing phase to help reduce falls. It also adjusts differences in force, speed and terrain during stance phase to create a more efficient gait. The Proprio foot can be used with a variety of shoes with different heel heights.
The Raize from Fillauer is a unique microprocessor ankle/foot system in a low profile, lightweight design. Its plantar/dorsi-flexion range reduces damaging forces on the residual limb and greatly enhances stability on slopes and slippery surfaces. By simply pressing a button the wearer can control rollover resistance, lock or unlock the ankle, and adjust the heel height as needed.
The Ottobock Empower features powered propulsion, which emulates the function of lost muscles and tendons and delivers energy rather than consuming it with each step. Empower also reduces stress on joints and offers patients the combination of power, control, and stability.
Multi-Axial and Dynamic Response Feet for the Active Amputee – Level K3 To K4.
Multi-axial feet conform to uneven surfaces. Besides moving up and down, a multi-axial foot can also move from side to side.
Dynamic response feet are for those who can vary walking speed, change directions quickly or walk long distances. They absorb energy when the heel contacts the ground and releases it as the foot leaves the ground. They provide a more normal range of motion and a more symmetric gait.
The multi-axial foot design of the Fillauer Ibex features a long carbon pylon and full-length heel plate that allows the Ibex to reach foot flat sooner and store more energy. The unique components of the Ibex provide stability without sacrificing energy return.
The MotionFoot MX from Fillauer is a hydraulic foot and ankle system with a natural range of ankle movement. Natural motion adjusts to slopes, various heel heights, and sitting with feet flat. Fully adjustable for nearly all levels of activity, the manual lock prevents unwanted movement in situations like driving, climbing ladders, or putting on shoes.
Ottobock Triton smart ankle makes walking easier, especially on slopes and ramps, offers more ground clearance at swing-through, noticeably relieves the residual limb, and reduces the need for compensating movements. With every step, the microprocessor identifies the need to adapt the angle of the ankle based on the user’s individual training data as well as the input generated by the sensors. The resulting adaptations make walking easier for the user not only on ramps, slopes and stairs, but also when walking at different speeds.
The Epirus from Blatchford provides more natural ankle motion and is designed for low to high impact K3 amputees who may enjoy occasional recreational sports. It’s a lightweight low-profile energy storing foot with multi-axial rotation.
Whether walking on a flat surface or traversing steep hills, the Fillauer AllPro performs to meet the amputee’s multi-axial needs. If exercise or sports are on the activity list, this “do-it-all” foot easily transitions from the gym to the tennis and basketball courts, as well as the soccer, football, and lacrosse fields.
Freedom Innovations Agilix is a multi-axial, shock absorbing flexible foot system designed to manage loading impacts, reduce socket shear forces and improve comfort while walking on nearly any terrain for K3 ambulators. Full-length dynamic heel attached at the toe ensures a seamless roll-over, for superior comfort and a more symmetrical gait. Lower profile and lighter weight allow users to do more and feel less tired at the end of the day.
The College Park TruPer is a multi-axial, dynamic-response foot made specifically for pediatric patients. It can be fitted to children as young as 3 years old. The TruPer also incorporates a foot shell with a split toe so children can wear shoes and sandals of their choice.
The College Park Trustep gives the user comfort and natural-feeling mobility. Its design provides correct movement in all planes allowing for nearly the same vertical motion, rotation and stability as an anatomical foot. With a full range of options available, the versatile design allows complete customization.
Össur Talux is a lightweight multi-axial foot designed to provide a combination of balance and agility. Emulating many anatomical features of the human foot, Talux has been specially designed to provide fluid, natural walking motion on a variety of terrains to users with low to moderate activity levels. Talux comes with a sandal toe for easy footwear selection.
Aeris Performance LP foot system from Fillauer is a 100% carbon composite foot using multiple springs to increase the range of flexibility and provide smooth, stable progression from heel-strike to toe-off.
Freedom Innovations THRIVE accommodates added weight when lifting or carrying heavy objects. THRIVE provides support for variable weight when it’s needed – resulting in a dynamic foot that feels the same regardless of load. Water-resistant
The Ottobock Trias is recommended for moderately active persons of all ages who require a lightweight, functional foot. Thanks to its low weight, the Trias is very comfortable. Appropriate for golf, cycling and hiking, the foot adapts to various walking speeds and surfaces without a loss of comfort, while simultaneously reducing strain on the sound limb.
The carbon fiber Ottobock Taleo is designed for active individuals who traverse varied indoor and outdoor environments. The user can move freely and comfortably on uneven or rolling terrain – no matter if at home or out on grassy areas, forest paths or rocky ground. Salt and freshwater alike are no problem for the Taleo. Water runoff channels on the connection adapter and openings in the sole of the foot let the water drain away.
Blatchford Esprit is a low-profile foot for moderate and high K level users. It provides excellent energy response and is an ideal foot for longer residual limbs or where additional components are required. Suitable for the ambulator who can traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
Blatchford Javelin is a lightweight foot for new and experienced amputees who desire a responsive foot with a sleek cosmetic profile. It offers good energy response over a range of low to moderate impact sports and activities. Its blade style design is lightweight and ideal for variable cadence walking.
Freedom Innovations Maverick Xtreme foot was designed for active K3 and K4 level ambulators who require a product with increased durability without compromising the desired energy storage/return and smooth roll-over during stance. The increased durability is a result of the fiberglass material and the innovative heel/keel design and provides a natural, flexible feel during activities of daily living and various strenuous exercises. This new lighter weight fiberglass option is waterproof and is available in a sandal toe option for greater lifestyle versatility.
Freedom Innovations Runway adjustable heel height prosthetic foot maintains appropriate foot alignment to provide knee stability and consistent performance at all heel heights. Users can adjust from a flat heel for sandals or walking barefoot at home, up to a 2-inch heel for dress shoes and even cowboy boots. Manufactured using carbon fiber, which stores and returns energy so that users can walk farther, faster, longer. Water-resistant.
Blatchford Echelon is a waterproof hydraulic ankle that absorbs and damps on impact, self-aligns on rough and sloping surfaces, then remains dorsiflexed at toe-off. These design features help reduce abnormal pressures at the socket interface and other joints, promote comfort and postural symmetry to help reduce the risk of falls and preserve musculoskeletal health.
Blatchford Elite2 is designed for high impact, all terrain walking as well as a variety of recreational sports. Lightweight, the independent e-carbon foot springs provide vertical shock absorption as well as efficient and responsive energy return.
The Soleus from College Park accommodates a moderate activity lifestyle up to the highest impact Paralympic athlete. It provides natural movement with a progressive, 3-staged response and superior range of motion. Saltwater tested and with an antimicrobial and a UV foot shell, the Soleus performs flawlessly at the pool, lake, ocean, or outback.
Freedom Innovations Renegade Original Z-Shock Technology offers vertical shock deflection and comfort. Through active tibial progression, energy is absorbed and redirected, helping an amputee walk or run smoothly and confidently at any speed. A 100% carbon-fiber shock design results in a durable, maintenance-free device that’s one-third the weight of traditional shock feet. As a result, amputees can walk farther and faster, expending less energy. Water-resistant.
The Element from Fillauer is ideal for active and moderately active amputees of all amputation levels. It supports each phase of foot function in the gait cycle from heel strike, to mid-stance, to toe off. The result is a foot with smoothness, stability and performance throughout the gait cycle.
Freedom Innovations Highlander provides active patients with long residual limbs an efficient and smooth gait with excellent energy return. A split toe provides excellent inversion-eversion, allowing users to walk and run with confidence on uneven terrain. The Highlander can be used with exoskeletal systems or users weighing up to 500 lbs. As a result, amputees once limited to lower functioning products can now enjoy the benefits provided by a premium energy storage and return device so they can walk farther, faster, longer. Water-resistant.
Freedom Innovations Kinterra Foot/Ankle System combines hydraulics and carbon fiber technology to provide low to moderate impact K3 ambulators an exceptionally normal walking gait – regardless of surface angle or speed. Features include increased ground contact and a more symmetrical gait; improved stability and safety, especially on slopes and varied terrain; reduced socket pressures for healthier residual limbs; enhanced comfort while sitting and squatting; and user confidence and satisfaction.
Fillauer’s Wave Comfort 3 brings an exceptional level of comfort to the low to moderate activity user. The tri-spring design elements provide seamless transition and stable progression from heel-strike to toe-off. The coupled springs react in a compliant manner that promotes a supple feel while maintaining the dynamic response expected in carbon composite feet. The smooth action of the heel rocker combined with the stable dynamics of the forefoot insure a “wave of comfort” from heel to toe.
College Park’s Velocity’s coupled toe springs work together to provide a progressive, dynamic response. The smooth roll-over makes for a comfortable walking foot that kicks into gear during high impact activities. The foot combines high functionality for thrill seekers and no maintenance to keep them on the go.
Össur’s Re-Flex Rotate is for the individual who walks aggressively or engages in activities that require some degree of rotation, such as swinging a golf club or other appliance. The internal titanium coil spring of Re-Flex Rotate both reduces impact and enhances control and comfort during everyday activities.
Össur’s Re-Flex Shock provides a high level of vertical shock absorption. Designed for users engaged in heavy duty activities and high impact sports, the foot offers dynamic energy return and responsiveness. Users experience both enhanced control and comfort during walking and other activities.
Össur Vari-Flex provides natural gait with less fatigue and ultimately less strain on the lower back and sound side, it is the ideal foot for any activity. Features include a split toe, which allows the foot to adjust to uneven surfaces, allowing amputees to walk with stability and comfort on uneven ground. The waterproof foot maintains prosthetic function under wet circumstances.
Össur’s Pro-Flex family of prosthetic feet feature a three-blade design with a footblade that incorporates a full effective toe lever and a more anatomical split toe. This design helps generate exceptional toe-off energy and a fluid, natural progression from heel strike to toe-off.
Pro-Flex models include the Pivot, XC Torsion and LP Torsion. The Pivot is a multi-blade foot, featuring a pivot mechanism. It lets you move easily and naturally, with an excellent range of ankle motion and powered push-off without a motor. It’s smooth, comfortable and adapts seamlessly to your daily needs.
The torsion models couple the mechanical power of Össur’s Pro-Flex design with shock absorption and rotational capabilities to facilitate a smooth gait and reduce shear forces on residual limbs, thereby helping to protect the user’s sound side. The Pro-Flex XC Torsion for users who enjoy hiking and jogging as well as walking on level ground. The Pro-Flex LP Torsion is specifically designed for users with longer residual limbs. The LP Torsion and XC Torsion both feature a lightweight anatomical foot cover with a steady-grip sole for barefoot stability on wet or slick surfaces and a sandal toe for a wide range of footwear, including flip flops.
RUSH Foot family
The RUSH Foot family from Proteor USA offers several models of feet including the ROGUE, HiPRO, RAMPAGE AND RUSH KID.
The vertical loading pylon of the ROGUE provides comfortable relief from high impact loading allowing the user to push the foot to the limits. Features include components made of advanced fiberglass composite, which is three times more flexible that most conventional prosthetic feet, biomimetic ankle action to simulate the human foot, extreme reliability for extended use in any high impact application, and rotational torsion relief to ease the impact to knees, hip and back.
The HiPro utilizes an innovative glass composite for enhanced flexibility. The glass composite has been proven not to break down in heavy use. With the upper and lower struts comprised of this glass composite, the HiPro foot carves out superior engineering and delivers realistic and responsive foot and ankle motion.
Built kid tough, the RUSH Kid pediatric foot can handle even the most extreme low or high clearance patient. Mud, water, sand … no problem! The all-terrain RUSH Kid was built with active kids in mind.
The RAMPAGE has the smooth roll-through, increased comfort, and all-terrain capability of its predecessors plus a more cosmesis-friendly option, with a lower overall product weight. A perfect solution for individuals seeking a blend of both cosmetic, and high-performance capabilities.
For Low to Moderate Activity – K2 Amputees
The Celsus from College Park multi-axial function provides solid footing even on challenging terrain. Just like the human foot, the Celsus adjusts quickly and easily to uneven surfaces. The lightweight design promotes confidence and security to accomplish favorite pastimes once again.
The Avalon from Blatchford with controlled ankle motion and smooth roll over offers the latest in biomimetic technology to K2 amputees. Users will experience more confidence, security and stability as they negotiate everyday obstacles. Twelve degrees of controlled ankle motion allow the user to safely negotiate stairs, ramps and environmental obstacles with increased confidence and security. The biomimetic ankle may help reduce socket pressure and make everyday activities less tiring, encouraging better overall health and well-being.
Össur K2 Sensation low-activity foot is a comfortable walking prosthesis with a flexible full-length fiberglass keel and multi-axial foam core. With smooth progression from heel strike to toe-off, K2 Sensation is designed to promote user confidence and stability. It is also available with the D/P Flexion hydraulic ankle model to help improve stability on ramps and when transitioning from sitting to standing. Swing phase dorsiflexion is designed to reduce the risk of trips and falls – one of the main concerns of low active amputees.
Kintrol Ankle/Foot from Freedom Innovations combines cutting edge Kinterra hydraulic ankle technology with the highest quality, aerospace-grade fiberglass foot designed to provide K2 ambulators the comfort and control they demand. Features include a 12-degree range of motion for increased ankle movement for a more natural gait; full-length, unbolted fiberglass keel for optimal flexibility and comfort, resulting in a smooth rollover; and active dorsi-assist spring aiding in toe clearance during swing phase to reduce toe stubbing.
For K4 Amputees Who Are Engaged in Sprinting and Running
These feet are designed for running or other high impact activities.
Össur Flex-Run with Nike Sole is appropriate for transfemoral and transtibial users participating in high impact or extreme activities such as recreational jogging, trail running, distance running and triathlons. It is available in both Standard and Junior (LP) models.
Össur Flex-Foot Cheetah is a custom-built, high performance carbon fiber foot made primarily for sprinting. Cheetah is recommended for transtibial users engaging in long distance running and who do not have clearance for Flex-Run with Nike Sole.
The Fillauer Obsidian Running Blades are available in a posterior mount option for kids and adults. The adult direct mount option offers a pyramid slide for a variety of alignment locations and easy adjustments. The Obsidian has an exclusive split-toe design for improved multi-axial function and cornering performance. The running blades offer a tire-grade tread that can grip surfaces from the track to the trail.
The new Obsidian Sprint Blade, intended for elite athletes, provides a curve hugging split toe along with a snap at toe-off that will push the elite to a new level.
The Nitro Running Foot from Freedom Innovations is a custom foot module engineered specifically for jogging and distance running. The foot is customized to user weight and running experience to provide the appropriate balance between strength and flexibility for high impact activities. A tall profile design is available for adult users while the short profile design requires less build height for petite users and children.
The Blatchford Blade XT is the complete solution for active users. It is suitable for everyday use as well as running, cycling and other sporting activities. It has been designed so that wearers don’t have to stop and change their prostheses between activities throughout the day. BladeXT is lightweight, flexible and responsive, yet durable. It delivers outstanding performance, ground compliance, comfort and postural support from the twin toe spring and traction heel, while its C-shaped toe spring is primed for optimal energy response. The result is a sports blade that offers the user versatility, security and the confidence to enjoy an active life. It’s ideal for cross training, running, and bat and ball sports.
The Ottobock Challenger is a multi-purpose foot developed for the varying demands from everyday walking to recreational sports. High deflection of the curved main spring provides excellent shock absorption, which is desired for court sports like tennis or basketball, and energy return for activities such as sprinting and long-distance running. The base spring and adjustable heel damping allow for stability and control during rapid movements, while walking, and while standing. The Challenger fits with most lower profile shoes and comes with exchangeable heel wedges to support a large variety of sports and other individual needs. Excellent choice for active individuals with below or above knee fittings.
Sidekicks from College Park are adjustable stubbie feet for foreshortened prostheses. They provide natural anatomical ankle motion and a flexible platform for bilateral, transfemoral amputees. Gait-matched and approved for water use, Sidekicks flex and plant in real-world environments for the ultimate balance and stability.
Ottobock Aqua Foot is a specialty foot for K1-3. The Aqua Foot is equipped with a grid-shaped sole tread and has excellent floor adhesion thanks to its material composition and moulding. It has a natural shape with defined toes and an abducted big toe. The contact surface is coated with sealing resin against water penetration and connected to a high-grade titanium foot adapter. Access to the adapter’s screw on the sole of the foot is sealed with a plug.
Partial Foot Prostheses
Silicone creates a functional and realistic partial foot prosthesis that is effective in protecting sensitive tissue and providing support, balance and spring. It is strong and compresses easily, allowing a snug fit in standard shoes. Painted to match color variations of the patient’s skin, the prosthesis has details such as veins, hair, and skin discoloration. The prosthesis may be worn while swimming or going barefoot.