How Does sach foot Work?

What is a prosthetic foot?

A prosthetic foot, or foot prosthesis, is an artificial replacement for part or all of your natural foot. Prosthetics substitute for body parts that you don’t have or that don’t work as they should. A prosthetic foot is primarily a mobility aid. It can enable you to walk on two feet when you couldn’t otherwise.

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Who might use a prosthetic foot?

You might use a prosthetic foot if you’ve had a lower extremity or foot amputation. Common reasons for lower extremity amputations include tumors, trauma, infection and peripheral arterial disease. Diabetes-related foot conditions are the most common reason for foot amputations, specifically.

What are the different types of prosthetic feet?

Different types of prosthetic feet offer different levels of functionality. Some are more rigid, and others move in different ways. Some offer more stability, and others more flexibility. Some accommodate more active lifestyles. Your prosthetist will help you select the right prosthesis for your needs and goals.

Types include:

Solid ankle cushioned heel (SACH) prosthetic foot

The SACH foot is the simplest type of prosthetic foot, and often the first type you’ll use. For most people, it’s not a permanent solution but a temporary one that you’ll wear until your permanent foot is ready. It has a rigid keel (center), with foam molded in the shape of a foot around it, and a rigid ankle.

The keel is the weight-bearing center of the foot that mimics the function of your foot’s arch. It provides support and shock absorption when you walk. A flexible keel stores and transfers energy as you walk by bending a little when you put weight on it. A rigid keel doesn’t do this, so walking is a bit clunkier.

Flexible keel prosthetic foot

An elastic keel or flexible keel foot is similar to a SACH foot, except that the keel gives a little when you walk. This helps the foot accommodate uneven terrain a little better. Everything else in the foot is rigid, making it very stable and easy to control. This foot can be helpful for limited walking if your leg is weak.

Axial prosthetic foot

Axial feet have mechanical ankle joints that mimic the movement of a natural ankle. There are two types: single-axis and multi-axis. A single-axis ankle moves up and down to help the foot accommodate an incline or decline. A multi-axis ankle also moves side to side, which helps with uneven surfaces. 

Axial feet allow limited walkers to walk in more places. They’re heavier than the simpler models, but they’re durable and offer good stability, especially for those with weak or unstable knees. The moveable ankles help to absorb some of the stress of walking that might otherwise transfer to your leg.

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Hydraulic ankle-foot

A hydraulic ankle-foot uses compressed fluid, such as water or oil, to provide a smooth, rocking motion at the ankle, heel and ball of the foot. This imitates the movement of a natural foot in different walking phases. Hydraulics provide good shock absorption and reduce pressure on the prosthesis socket.

Dynamic-response prosthetic toot

A dynamic response foot provides more flexibility for more physically active users. It’s a contoured foot made with strong but flexible materials, like carbon fiber and foam, that spring back when you push off it. This helps to recycle some of the force you generate by walking, so it takes less energy to walk.

Dynamic response feet are also called energy-storage-and-return (ESAR) feet. They walk for longer distances with more comfort and with a more natural gait than simpler models. They can change speed or direction with ease, making them versatile for many uses. Most sports feet are ESAR models.

Microprocessor prosthetic foot

A microprocessor foot has computer chips and sensors that detect how you’re using the foot and what the terrain is like and make automatic adjustments. This improves overall mobility and relieves stress and strain when walking. Because it uses advanced technology, it’s sometimes called a bionic foot.

Microprocessor feet are battery-powered and require charging at night. They’re more expensive and less durable than other models, and you can’t let them get too wet or dirty. They’re also heavier, although some models use their electric power to help propel the foot, doing some of the work for you.

Specialty prosthetic feet

You might use an alternate prosthetic foot for certain sports or activities. Some of these include:

• Running.
• Swimming.
• Showering.
• Rock climbing.
• Skiing.
• Golf.

Partial foot prostheses

If you have a partial foot amputation, you might benefit from a partial foot prosthesis. Options include:

This is one of many examples of dynamic response feet, which are indicated for people whose gait patterns generate enough energy to be worth storing. For this reason, some prosthetists call them "energy storing feet." They incorporate elastic keel structures that absorb energy during midstance and terminal stance, and then "release" it during preswing and initial swing. Many types are available, including the College Park Foot (pictured here), the Otto Bock Dynamic Foot, the Flex Foot, the Seattle Foot, the Quantum Foot, and the Carbon Copy II. The durability of some new materials is not fully tested.

For an excellent summary of dynamic response feet, see Edelstein, J.E. (). Prosthetic feet: State of the art. Physical Therapy, 68, -.

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