User preference has the potential to facilitate the design, control, and prescription of prostheses, but we do not yet understand which physiological factors drive preference, or if preference is associated with clinical benefits. Subjects with unilateral below-knee amputation walked on a custom variable-stiffness prosthetic ankle and manipulated a dial to determine their preferred prosthetic ankle stiffness at three walking speeds. We evaluated anthropomorphic, metabolic, biomechanical, and performance-based descriptors at stiffness levels surrounding each subject’s preferred stiffness. Subjects preferred lower stiffness values at their self-selected treadmill walking speed, and elected to walk faster overground with ankle stiffness at or above their preferred stiffness. Preferred stiffness maximized the kinematic symmetry between prosthetic and unaffected joints, but was not significantly correlated with body mass or metabolic rate. These results imply that some physiological factors are weighted more heavily when determining preferred stiffness, and that preference may be associated with clinically relevant improvements in gait.

中文翻译：

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了解患者对假肢踝关节僵硬的偏好

用户偏好有可能促进假肢的设计、控制和处方，但我们尚不清楚哪些生理因素驱动偏好，或者偏好是否与临床益处相关。单侧膝下截肢的受试者在定制的可变刚度假肢脚踝上行走，并操纵刻度盘以确定他们在三种步行速度下首选的假肢脚踝刚度。我们在围绕每个受试者首选硬度的硬度水平上评估了拟人化、代谢、生物力学和基于性能的描述符。受试者在自己选择的跑步机行走速度下更喜欢较低的刚度值，并选择在脚踝刚度等于或高于其首选刚度的情况下在地面上走得更快。首选刚度最大化了假肢和未受影响关节之间的运动学对称性，但与体重或代谢率没有显着相关。这些结果意味着，在确定首选刚度时，一些生理因素的权重更大，并且该偏好可能与临床相关的步态改善有关。