{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:52:46Z","timestamp":1792554766680,"version":"4.5.0"},"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["RX002634"],"award-info":[{"award-number":["RX002634"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["RX004256"],"award-info":[{"award-number":["RX004256"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007249","name":"University of Minnesota","doi-asserted-by":"publisher","award":["UMII-GA-0866719453"],"award-info":[{"award-number":["UMII-GA-0866719453"]}],"id":[{"id":"10.13039\/100007249","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Changing footwear often presents a challenge for lower extremity prosthesis users. When prosthesis alignment is completed by the Certified Prosthetist, the prosthetic foot is set at an angle accommodating a single shoe heel rise (shoe heel height minus forefoot height); deviation from this heel rise causes misalignment of the prosthesis. To address this problem, the Rehabilitation &amp; Engineering Center for Optimizing Veteran Engagement &amp; Reintegration (RECOVER) has developed a modular ankle-feet system allowing for the use of footwear of varying heel rises without the need for realignment by the prosthesis user. The primary aim of this study was to understand if clinically acceptable prosthesis alignment is maintained as prosthesis users change between modular foot-shoe sets. Three women transtibial prosthesis users self-selected three pairs of footwear with a heel rise up to 10\u2009cm. Using the modular prosthetic ankle-feet system, participants completed five walking trials per foot-shoe set in the motion analysis laboratory. Reflective markers were used to track the location of the prosthetic socket during walking. These data in combination with center of pressure measurements were used to calculate ankle-foot-shoe rollover shapes and the location of the origin of the best-fit circle for each rollover shape. The locations of the resulting best-fit circle origins indicate prosthesis alignment is maintained within clinically acceptable parameters as users change between foot-shoe sets. These findings have implications for improving footwear options for people with lower-extremity amputations.<\/jats:p>","DOI":"10.1371\/journal.pone.0323647","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T17:53:42Z","timestamp":1748454822000},"page":"e0323647","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Functional dynamic prosthesis alignment maintained across varying footwear using a modular prosthetic ankle-feet system"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2813-9293","authenticated-orcid":true,"given":"Nicole R.","family":"Walker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3599-8330","authenticated-orcid":true,"given":"Myrriah P.","family":"Laine Dyreson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan E.","family":"Cave II","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kali R.","family":"Mansur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly J.","family":"Yun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Looft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew H.","family":"Hansen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"issue":"4","key":"pone.0323647.ref001","first-page":"201","article-title":"Technical note","volume":"3","author":"AE Price","year":"1991","journal-title":"J Prosthet Orthot"},{"issue":"3","key":"pone.0323647.ref002","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1682\/JRRD.2013.01.0010","article-title":"Development of inexpensive prosthetic feet for high-heeled shoes using simple shoe insole model","volume":"51","author":"MR Meier","year":"2014","journal-title":"J Rehabil Res Dev"},{"issue":"2","key":"pone.0323647.ref003","first-page":"2","article-title":"Alignment of lower-limb prostheses","volume":"23","author":"MS Zahedi","year":"1986","journal-title":"J Rehabil Res Dev"},{"key":"pone.0323647.ref004","doi-asserted-by":"crossref","unstructured":"Nickel E, Voss G, Slater B, Mueller E, Hansen A. Improving footwear options for persons with lower limb amputations. In: Proceedings of the American Society of Mechanical Engineers. 2020. https:\/\/doi.org\/10.1115\/DMD2020-9044","DOI":"10.1115\/DMD2020-9044"},{"issue":"2","key":"pone.0323647.ref005","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1080\/03093640308726664","article-title":"Alignment of trans-tibial prostheses based on roll-over shape principles","volume":"27","author":"AH Hansen","year":"2003","journal-title":"Prosthet Orthot Int"},{"issue":"1","key":"pone.0323647.ref006","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","volume":"21","author":"AH Hansen","year":"2009","journal-title":"J Prosthet Orthot"},{"issue":"4","key":"pone.0323647.ref007","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1080\/03093640802366158","article-title":"Effects of alignment on the roll-over shapes of prosthetic feet","volume":"32","author":"A Hansen","year":"2008","journal-title":"Prosthet Orthot Int"},{"issue":"9","key":"pone.0323647.ref008","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1682\/JRRD.2010.07.0136","article-title":"Effect of prosthetic ankle units on roll-over shape characteristics during walking in persons with bilateral transtibial amputations","volume":"48","author":"SA Gard","year":"2011","journal-title":"J Rehabil Res Dev"},{"issue":"6","key":"pone.0323647.ref009","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1682\/JRRD.2010.01.0003","article-title":"Effects of prosthetic foot forefoot flexibility on oxygen cost and subjective preference rankings of unilateral transtibial prosthesis users","volume":"47","author":"E Klodd","year":"2010","journal-title":"J Rehabil Res Dev"},{"issue":"4","key":"pone.0323647.ref010","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1682\/JRRD.2003.06.0098","article-title":"Effects of shoe heel height on biologic rollover characteristics during walking","volume":"41","author":"AH Hansen","year":"2004","journal-title":"J Rehabil Res Dev"},{"issue":"26","key":"pone.0323647.ref011","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.3109\/09638288.2010.502586","article-title":"Investigations of roll-over shape: implications for design, alignment, and evaluation of ankle-foot prostheses and orthoses","volume":"32","author":"AH Hansen","year":"2010","journal-title":"Disabil Rehabil"},{"key":"pone.0323647.ref012","author":"A Hansen","year":"2002"},{"issue":"4","key":"pone.0323647.ref013","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.clinbiomech.2003.12.001","article-title":"Roll-over shapes of human locomotor systems: effects of walking speed","volume":"19","author":"AH Hansen","year":"2004","journal-title":"Clin Biomech (Bristol)"},{"key":"pone.0323647.ref014","first-page":"1","article-title":"Effects of footwear on the gait kinematics of women with unilateral transtibial amputation: an observational case series","author":"J Kent","year":"2022","journal-title":"Disabil Rehabil"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0323647","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T17:53:48Z","timestamp":1748454828000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0323647"}},"subtitle":[],"editor":[{"given":"Yih-Kuen","family":"Jan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,28]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0323647","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,28]]}}}