







































 

 

 Tomkin M, Gholizadeh H, Sinitski E, Lemaire E.D. TRANSTIBIAL AMPUTEE GAIT WITH THE PRO-FLEX FOOT DURING LEVEL, DECLINE, AND INCLINE WALKING. CANADIAN 
PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, 
CANADA, 2018 . https://doi.org/10.33137/cpoj.v1i2.32003                                                                          

 

1 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (POSTER PRESENTATION) 

TRANSTIBIAL AMPUTEE GAIT WITH THE PRO-FLEX FOOT DURING LEVEL, 

DECLINE, AND INCLINE WALKING  

Matthew Tomkin1,2*, Hossein Gholizadeh1,3, Emily Sinitski1,4, Edward D Lemaire1,5 

 
1Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Canada. 
2Ottawa-Carleton Institute for Biomedical Engineering, University of Ottawa, Canada. 
3Prosthetics & Orthotics, The Ottawa Hospital Rehabilitation Centre, Canada. 
4Canadian Forces Health Services, Canada. 
5Faculty of Medicine, University of Ottawa, Canada. 

* Email: mtomk062@uottawa.ca 

 

INTRODUCTION 

The Össur Pro-Flex is a 3-blade carbon fiber prosthetic 

foot designed to provide greater ankle range of motion 

compared to conventional energy storing and returning 

prosthetic feet1,2. To provide knowledge on  

Pro-Flex biomechanical performance, kinematic and 

kinetic gait parameters were evaluated and compared 

with the Össur Pro-Flex XC prosthetic foot. Outcomes 

from this study provide clinical professionals with 

important decision-making knowledge about two 

innovative energy storing and returning prosthetic feet. 

METHODS 

Three K3 unilateral transtibial amputees were fitted with 

the Pro-Flex  and the Össur Unity vacuum suspension 

system. All participants were previously fitted with the 

Pro-Flex XC and Unity system. Participants completed a 

warm-up trial and multiple self-paced walking trials in a 

virtual park (CAREN-extended virtual reality system)3. 

3D motion was evaluated on level, 7° decline, and 7° 

incline walking conditions. 

RESULTS 

Pro-Flex ankle range of motion increased compared to 

the Pro-Flex XC during all conditions. Ankle push-off 

power was greater with the Pro-Flex XC during level and 

incline walking; however, similar power was observed 

during decline walking. 

 

Table 1. Mean and standard deviation for ankle range of 

motion (°). 

 

 

Table 2. Mean and standard deviation for ankle push-off 

power (W/kg). 

 

CONCLUSION 

Pro-Flex ankle range of motion was greater than Pro-Flex 

XC; however, Pro-Flex range of motion was smaller than 

reported by Heitzmann et al.1, perhaps due to differences 

in methodologies and study populations (e.g., Heitzmann 

had K3 and K4 participants). As expected, Pro-Flex peak 

ankle power generation did not surpass Pro-Flex XC 

during any of the conditions, since Pro-Flex XC was 

designed to generate appropriate power over a larger 

variety of activities and impact levels compared to Pro-

Flex4. 

SIGNIFICANCE 

Pro-Flex provided greater ankle range of motion during 

level and slope self-paced walking, which may reduce 

compensatory gait strategies on sloped surfaces. 

However, the K3 participants may not have taken full 

advantage of Pro-Flex’s ankle range of motion potential. 

While push-off powers were similar between feet,  

Pro-Flex XC was designed for higher activity and 

achieved greater energy return. Further research is 

required to identify when people benefit from greater 

ankle range of motion while maintaining ankle push-off 

power. Future studies with high activity transtibial and 

transfemoral amputees will provide a broader 

understanding about Pro-Flex’s biomechanical 

performance. 

DOI: https://doi.org/10.33137/cpoj.v1i2.32003  

https://doi.org/10.33137/cpoj.v1i2.32003
mailto:mtomk062@uottawa.ca
https://doi.org/10.33137/cpoj.v1i2.32003


 

 

 Tomkin M, Gholizadeh H, Sinitski E, Lemaire E.D. TRANSTIBIAL AMPUTEE GAIT WITH THE PRO-FLEX FOOT DURING LEVEL, DECLINE, AND INCLINE WALKING. CANADIAN 
PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, 
CANADA, 2018 . https://doi.org/10.33137/cpoj.v1i2.32003                                                                          

 

2 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (POSTER PRESENTATION) 

 
Figure 1. Mean prosthetic ankle angle and power during level, decline, and incline walking. Pro-Flex standard deviation in gray. 

 

ACKNOWLEDGE 

This study was financially supported by Mitacs and 

prosthetic components were provided by Össur. 

Courtney Bridgewater and Andrew Smith are 

acknowledged for their assistance with motion capture 

and data processing. 

REFERENCES 

1. Heitzmann, Daniel WW, et al. "Benefits of an increased 

prosthetic ankle range of motion for individuals with a trans-

tibial amputation walking with a new prosthetic foot." Gait & 

Posture, 64, 174-180, 2018. 

https://doi.org/10.1016/j.gaitpost.2018.06.022 

 

 

 

2. Össur [Internet]. c2018 [cited 2018 Aug 14]. Pro-Flex. 

Available from: https://www.ossur.com/prosthetic- solutions/ 

products/dynamic-solutions/pro-flex.  

3. E. H. Sinitski, E. D. Lemaire, and N. Baddour, “Evaluation 

of motion platform embedded with force plate-instrumented 

treadmill.” J. Rehabil. Res. Dev., 52(2), 221–233, 2015. doi: 

10.1682/JRRD.2013.11.0244. 

4. Össur [Internet]. c2018 [cited 2018 Aug 14]. Pro-Flex XC. 

Available from: https://www.ossur.com/prosthetic-solutions/ 

products/ dynamic-solutions/pro-flex-xc.   

 

https://doi.org/10.33137/cpoj.v1i2.32003
https://doi.org/10.1016/j.gaitpost.2018.06.022
doi:%2010.1682/JRRD.2013.11.0244.
doi:%2010.1682/JRRD.2013.11.0244.

