9.2.7 Walking up a ramp
With the first step, the foot is already adjusted to the inclination of the ramp, making a
rollover possible if the step is on the heel or middle of the foot. In order to do so, the lower
leg should positioned almost perpendicular to the surface of the ramp and the full area of the
foot should be placed on the surface.
When stepping on the forefoot with the lower leg at a steep angle (e.g. on very steep
ramps), the foot secures dorsiflexion, which enables the body to be lifted in a stable manner.
9.2.8 Walking down a ramp
With the first step, the foot is already adjusted to the inclination of the ramp, making it pos
sible for the heel to strike with extended plantar flexion so the complete area of the foot is on
the surface during the rollover.
After the foot is put down on the ramp, you should not use the knee to work against it, but
should allow flexion in the knee joint for the heel strike (yielding). Only in this way will the
foot be able to recognise the motion as walking and allow an extended rollover. This allows
for a guided lowering of the body's centre of gravity.
Plantar flexion is limited for walking with a prosthetic knee joint (higher amputation level than
transtibial amputation) in order to support flexion in the knee joint during heel strike (yield
ing).
9.2.9 Walking backwards
The foot enables plantar flexion from the stance phase when walking backwards. When the
toe is subsequently put down, the ankle joint drops to the neutral position in the dorsiflexion
direction.
9.2.10 Standing on inclined surface
Standing on an inclined ground surface is no different to standing on a level surface. The
foot stabilises in dorsiflexion when the lower leg is perpendicular. Put weight on the heel in
order to lower the forefoot (e.g. when standing in a downward direction).
Perform one of the following motions in order to continue to walk on a downward-sloping
ground surface from the standing position:
•
Start the first step with the prosthesis side.
•
Deliberately produce a rollover motion with the prosthesis side.
The prosthetic foot then yields in dorsiflexion, in order to allow the body's centre of grav
ity to drop before the heel of the other leg strikes.
The relief function can be used when standing on an inclined surface (see page 66).
Wearing shoes with heels limits the range of incline, so it may not be possible to achieve a
perpendicular lower leg.
65
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