The effect of alignment changes on unilateral transtibial amputee's gait: a systematic review

Niels Jonkergouw, Maarten R. Prins, Arjan W.P. Buis, Peter van der Wurff

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)
119 Downloads (Pure)


Introduction: Prosthetic alignment, positioning of a prosthetic foot relative to a socket, is an iterative process in which an amputee’s gait is optimized through repetitive optical gait observation and induction of alignment adjustments when deviations are detected in spatiotemporal and kinematic gait parameters. An important limitation of the current prosthetic alignment approach is the subjectivity and the lack of standardized quantifiable baseline values. The purpose of this systematic review is to investigate if an optimal alignment criterion can be derived from published articles. Moreover, we investigated the effect of alignment changes on spatiotemporal, kinematic and kinetic gait parameters.
Results: A total of 11 studies were included, two controlled before-and-after studies and nine-interrupted time series studies.
Discussion: The results demonstrate that alignment changes have a predictable influence on the included kinetic parameters. However, the effect of alignment changes on spatio-temporal and kinematic gait parameters are generally unpredictable. These findings suggest that it is imperative to include kinetics in the process of dynamic prosthetic alignment. Partially this can be established by communication with the prosthetic user in terms of perceived socket comfort, but the use of measurement tools should also be considered. While current literature is not conclusive about an optimal alignment, future alignment research should focus on alignment optimisation based on kinetic outcomes.
Original languageEnglish
Article numbere0167466
Number of pages18
JournalPLOS One
Issue number12
Publication statusPublished - 6 Dec 2016


  • alignment
  • amputee
  • below the knee
  • gait analysis
  • kinematic
  • kinetic analysis
  • Prosthetics
  • quantification
  • spatio-temporal
  • trans-tibial


Dive into the research topics of 'The effect of alignment changes on unilateral transtibial amputee's gait: a systematic review'. Together they form a unique fingerprint.

Cite this