{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T10:57:25Z","timestamp":1760785045948,"version":"3.37.3"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH-17-2-0072"],"award-info":[{"award-number":["W81XWH-17-2-0072"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The loaded mechanical function of transtibial prostheses that result from the clinical assembly, tuning, and alignment of modular prosthetic components can directly influence an end user\u2019s biomechanics and overall mobility. Footwear is known to affect prosthesis mechanical properties, and while the options of footwear are limited for most commercial feet due to their fixed geometry, there exists a selection of commercial prosthetic feet that can accommodate a moderate rise in heel height. These feet are particularly relevant to women prosthesis users who often desire to don footwear spanning a range of heel heights. The aim of this study was to assess the effects of adding women\u2019s footwear (flat, trainer, 5.08 cm heel) on the mechanical properties (deformation and energy efficiency) of four models of heel-height accommodating prosthetic feet. Properties were measured through loading-unloading at simulated initial contact, midstance and terminal stance orientations with a universal materials test system, and statistically compared to a barefoot condition. Results suggest that the addition of footwear can alter the level of foot deformation under load, which may be a function of the shoe and alignment. Moreover, while each foot displayed different amounts of energy storage and return, the addition of footwear yielded similar levels of energy efficiency across foot models. Overall, prosthesis users who don shoes of varying heel heights onto adjustable prosthetic feet and their treating clinicians should be aware of the potential changes in mechanical function that could affect the user experience.<\/jats:p>","DOI":"10.1371\/journal.pone.0262910","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T18:32:30Z","timestamp":1643049150000},"page":"e0262910","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of women\u2019s footwear on the mechanical function of heel-height accommodating prosthetic feet"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2330-4619","authenticated-orcid":true,"given":"Matthew J.","family":"Major","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9089-7322","authenticated-orcid":true,"given":"Julia","family":"Quinlan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew H.","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Russell Esposito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"issue":"3\u20134","key":"pone.0262910.ref001","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1080\/10833196.2017.1346033","article-title":"Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes","volume":"22","author":"MJ Major","year":"2017","journal-title":"Physical Therapy Reviews"},{"issue":"1","key":"pone.0262910.ref002","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1186\/s12984-021-00939-8","article-title":"Reducing stiffness of shock-absorbing pylon amplifies prosthesis energy loss and redistributes joint mechanical work during walking","volume":"18","author":"JA Maun","year":"2021","journal-title":"J Neuroeng Rehabil"},{"issue":"1","key":"pone.0262910.ref003","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s12984-018-0432-5","article-title":"Amputee perception of prosthetic ankle stiffness during locomotion","volume":"15","author":"MK Shepherd","year":"2018","journal-title":"J Neuroeng Rehabil"},{"key":"pone.0262910.ref004","first-page":"52","article-title":"Patient-Preferred Prosthetic Ankle-Foot Alignment for Ramps and Level-Ground Walking. IEEE transactions on neural systems and rehabilitation engineering: a publication of the","volume":"29","author":"MK Shepherd","year":"2021","journal-title":"IEEE Engineering in Medicine and Biology Society"},{"issue":"3","key":"pone.0262910.ref005","doi-asserted-by":"crossref","first-page":"168","DOI":"10.3109\/03093649709164550","article-title":"Optimisation of the prescription for trans-tibial (TT) amputees","volume":"21","author":"A Cort\u00e9s","year":"1997","journal-title":"Prosthet Orthot Int"},{"issue":"4","key":"pone.0262910.ref006","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1109\/86.650279","article-title":"Prosthetic weight acceptance mechanics in transtibial amputees wearing the single axis, seattle lite, and flex foot","volume":"5","author":"J Perry","year":"1997","journal-title":"IEEE Transactions on Rehabilitation Engineering"},{"issue":"3","key":"pone.0262910.ref007","first-page":"299","article-title":"Mechanical properties of prosthetic limbs: adapting to the patient","volume":"38","author":"GK Klute","year":"2001","journal-title":"Journal of Rehabilitation Research and Development"},{"issue":"2","key":"pone.0262910.ref008","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/0309364617706749","article-title":"The effects of common footwear on stance-phase mechanical properties of the prosthetic foot-shoe system","volume":"42","author":"MJ Major","year":"2018","journal-title":"Prosthetics and Orthotics International"},{"key":"pone.0262910.ref009","article-title":"Focusing Research Efforts on the Unique Needs of Women Prosthesis Users.","author":"MJ Major","year":"2021","journal-title":"JPO: Journal of Prosthetics and Orthotics"},{"issue":"4","key":"pone.0262910.ref010","first-page":"201","article-title":"Technical Note: Interchangeable Feet","volume":"3","author":"AE Price","year":"1991","journal-title":"J Prosthet Orthot"},{"volume-title":"VETERANS HEALTH CARE: Agency Efforts to Provide and Study Prosthetics for Small but Growing Female Veteran Population","year":"2020","author":"United States Government Accountability Office","key":"pone.0262910.ref011"},{"issue":"1","key":"pone.0262910.ref012","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1097\/JPO.0b013e318191c902","article-title":"Effects of Shoe Heel Height on the Roll-Over Shapes of Prosthetic Ankle-Foot Systems: Implications for Heel-Height-Adjustable Components. JPO","volume":"21","author":"AH Hansen","year":"2009","journal-title":"Journal of Prosthetics and Orthotics"},{"issue":"3","key":"pone.0262910.ref013","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/0309364617741937","article-title":"Creative prosthetic foot selection enables successful ambulation in stiletto high heels","volume":"42","author":"E Russell Esposito","year":"2018","journal-title":"Prosthet Orthot Int"},{"issue":"3","key":"pone.0262910.ref014","doi-asserted-by":"crossref","first-page":"117","DOI":"10.3109\/03093649009080337","article-title":"Stiffness and hysteresis properties of some prosthetic feet","volume":"14","author":"HW van Jaarsveld","year":"1990","journal-title":"Prosthetics and Orthotics International"},{"key":"pone.0262910.ref015","first-page":"2021","article-title":"Perceived Footwear Limitations in Women Prosthesis Users and Their Impact on Patient Reported Outcomes","author":"E Russell Esposito","year":"2021","journal-title":"American Academy of Orthotists & Prosthetists 47th Academy Annual Meeting & Scientific Symposium"},{"issue":"4","key":"pone.0262910.ref016","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1682\/JRRD.2014.12.0300","article-title":"Inter-rater reliability of mechanical tests for functional classification of prosthetic components","volume":"52","author":"MJ Major","year":"2015","journal-title":"Journal of Rehabilitation Research and Development"},{"year":"2016","author":"International Organization for Standardization","key":"pone.0262910.ref017"},{"issue":"1","key":"pone.0262910.ref018","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.clinbiomech.2013.10.012","article-title":"The effects of prosthetic ankle stiffness on ankle and knee kinematics, prosthetic limb loading, and net metabolic cost of trans-tibial amputee gait","volume":"29","author":"MJ Major","year":"2014","journal-title":"Clin Biomech (Bristol, Avon)."},{"issue":"9","key":"pone.0262910.ref019","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1682\/JRRD.2009.10.0166","article-title":"Effects of prosthetic foot forefoot flexibility on gait of unilateral transtibial prosthesis users","volume":"47","author":"E Klodd","year":"2010","journal-title":"Journal of Rehabilitation Research and Development"},{"year":"2020","author":"MJ Major","key":"pone.0262910.ref020"},{"key":"pone.0262910.ref021","article-title":"Sensitivity of biomechanical outcomes to independent variations of hindfoot and forefoot stiffness in foot prostheses","author":"PG Adamczyk","year":"2017","journal-title":"Human movement science"},{"issue":"1","key":"pone.0262910.ref022","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1123\/jab.28.1.20","article-title":"Walking on high heels changes muscle activity and the dynamics of human walking significantly","volume":"28","author":"EB Simonsen","year":"2012","journal-title":"Journal of applied biomechanics"},{"key":"pone.0262910.ref023","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.gaitpost.2018.01.036","article-title":"Effects of high heeled shoes on gait","volume":"61","author":"MM Wiedemeijer","year":"2018","journal-title":"A review. Gait Posture"},{"issue":"3","key":"pone.0262910.ref024","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1123\/jab.16.3.309","article-title":"The Influence of High Heeled Shoes on Kinematics, Kinetics, and Muscle EMG of Normal Female Gait","volume":"16","author":"DJ Stefanyshyn","year":"2000","journal-title":"Journal of applied biomechanics"},{"issue":"4","key":"pone.0262910.ref025","doi-asserted-by":"crossref","first-page":"190","DOI":"10.2519\/jospt.1994.19.4.190","article-title":"Lower extremity mechanics and energy cost of walking in high-heeled shoes","volume":"19","author":"CJ Ebbeling","year":"1994","journal-title":"The Journal of orthopaedic and sports physical therapy"},{"issue":"1","key":"pone.0262910.ref026","doi-asserted-by":"crossref","first-page":"27","DOI":"10.7547\/87507315-93-1-27","article-title":"Kinetics of high-heeled gait","volume":"93","author":"M Esenyel","year":"2003","journal-title":"J Am Podiatr Med Assoc"},{"issue":"5","key":"pone.0262910.ref027","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1177\/0309364616683980","article-title":"Instantaneous stiffness and hysteresis of dynamic elastic response prosthetic feet","volume":"41","author":"CM Webber","year":"2017","journal-title":"Prosthet Orthot Int"},{"key":"pone.0262910.ref028","unstructured":"International Organization for Standardization. ISO\/TS 16955:2016. Prosthetics\u2014Quantification of physical parameters of ankle foot devices and foot units. Geneva, Switzerland: International Organization for Standardization; 2016."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262910","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T18:32:54Z","timestamp":1643049174000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0262910"}},"subtitle":[],"editor":[{"given":"Arezoo","family":"Eshraghi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,1,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0262910","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,1,24]]}}}