Walking Down A Ramp; Walking Backwards; Standing On Inclined Surface - Ottobock Meridium 1B1 Instrucciones De Uso

8.2.8 Walking down a ramp

With the first step, the foot is already adjusted to the inclination of the ramp,
making it possible 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 ampu­
tation level than transtibial amputation) in order to support flexion in the knee
joint during heel strike (yielding).

8.2.9 Walking backwards

When the toe is put down first while walking backwards, the ankle joint only
drops as far as the neutral position in the dorsiflexion direction. As a result, the
preceding rollover motion is balanced out and the user can stand safely.
Dorsiflexion can lead to flexion in the knee joint.
8.2.10 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 sur­
face.
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 lif­
ted in a stable manner.

8.2.11 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 down­
ward-sloping ground surface from the standing position:
•
•
The relief function can be used when standing on an inclined surface (see
Page 56).
Wearing shoes with heels limits the range of incline, so it may not be possible
to achieve a perpendicular lower leg.
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 gravity to drop before the heel of the other leg strikes.
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