500 Section - Microprocessor-Controlled Prostheses for a Bilateral Transtibial Amputee with Gait analysis and satisfaction : A 1-Year Followup Case Report

Case Diagnosis: A 70-year-old male with bilateral transtibial amputation from a landmine explosion experienced long-term gait limitations and instability using conventional passive prostheses. Despite transitioning from SACH feet to dynamic response feet, he continued to report high energy demand, discomfort, and restricted outdoor mobility. His condition represented a typical case of bilateral transtibial amputee gait dysfunction, requiring enhanced ankle control and improved adaptation to varied terrain

Case Description: The patient was fitted with the South Korean microprocessor-controlled prosthetic ankle (MPA), RoFT®, and underwent gait assessments with CPA, after 1 month of MPA use, and after 1 year. A 3D motion capture system and force platforms quantified spatiotemporal, kinematic, and kinetic parameters. Satisfaction was evaluated using a modified K-PEQ. The study aimed to determine whether long-term MPA use could improve gait performance and user experience in a bilateral transtibial amputee.

Discussions: MPA use improved single support time, step width, and gait symmetry. Ankle kinematics showed more physiologic plantarflexion during loading response and increased dorsiflexion in late stance. Although initial plantarflexion power was reduced at 1 month, it improved after 1 year, indicating adaptation. Questionnaire data favored the MPA in balance, comfort, skin issues, and mobility. Weight and noise were noted limitations, but overall functional gains were substantial for a bilateral amputee without a sound limb for compensation.

Conclusions: The RoFT® MPA facilitated more physiologic and stable gait over one year, improving symmetry, ankle motion, and mobility in varied terrain. Despite drawbacks such as weight and operating noise, the patient demonstrated meaningful functional progress and high satisfaction. This case supports MPA use as a beneficial option for bilateral transtibial amputees and highlights the need for broader patient studies.