Enhancing the quality of life of people with a lower limb amputation is critical in prosthetic development and rehabilitation. Yet, no overview is available concerning the impact of passive, quasi-passive and active ankle-foot prostheses on quality of life.
To systematically review the therapeutic benefits of performing daily activities with passive, quasi-passive and active ankle-foot prostheses in people with a lower limb amputation. 
We searched the Pubmed, Web of Science, Scopus and Pedro databases, and backward citations until November 3, 2021. Only English-written randomised controlled trials, cross-sectional, cross-over and cohort studies were included when the population comprised individuals with a unilateral transfemoral or transtibial amputation, wearing passive, quasipassive or active ankle-foot prostheses. The intervention and outcome measures had to include any aspect of quality of life assessed while performing daily activities. We synthesised the participants' characteristics, type of prosthesis, intervention, outcome and main results, and conducted risk of bias assessment using the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021290189.
We identified 4281 records and included 34 studies in total. Results indicate that quasi-passive and active prostheses are favoured over passive prostheses in the short-term. None of the included studies investigated the long-term effects of the prostheses, and none of the studies compared active with quasi-passive prostheses. Among the included studies, quality of life has been evaluated in the short-term using biomechanical (n = 26), physiological (n = 10), performance-related (n =19) or subjective measures (n = 10). These measures were collected during level walking (n = 34), slope walking (n = 9), standing (n = 2), circuit walking (n = 1), stair climbing (n = 1), standardized clinical tests (n = 1) and rock climbing (n = 1). All studies had a moderate to high risk of bias.
Compared to passive ankle-foot prostheses, quasi-passive and active prostheses significantly enhance the quality of life. Although short-term therapeutic benefits have been established favouring more advanced prostheses, outcome
measures' discrepancies prevail, and the long-term benefits remain unknown. Investigating these aspects within prosthetic development and evaluation may improve the quality of life of people with a lower limb amputation.
Originele taal-2English
UitgeverijProsthetics and Orthotics International
Aantal pagina's1
StatusPublished - 13 apr 2023
EvenementISPO 19th World Congress - , Mexico
Duur: 24 apr 202327 apr 2023


ConferenceISPO 19th World Congress


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