As of 2005, approximately 35% of the 1.6 million people living with limb loss in the United States were female. Women with amputations face unique considerations and encounter a variety of different issues than men, including greater dissatisfaction with prosthetic fit and appearance, as well as limitations in footwear and attire. Having the choice to wear footwear appropriate for a given occasion can be an important part of community reintegration after an amputation and a return to pre-injury activities can include a return to walking in the desired footwear. However, footwear can alter the mechanical properties of the prosthetic foot. Several studies have demonstrated how footwear impacts the intended stiffness and energy return properties of a prosthetic foot but only men’s-specific footwear and loading parameters have been investigated. Thus, understanding what footwear female prosthesis users wear and how women’s-specific footwear, to include high heels, impacts the function of the prosthetic foot are important considerations during the prescription and rehabilitation processes.

The purpose of this study is to address footwear challenges unique to female prosthesis users. The specific aims of this investigation are to determine (1) the types of footwear worn and desired to be worn by female prosthesis users, as well as perceived limitations when wearing and using different footwear, and (2) how women’s-specific footwear alters the stiffness and energy return of prosthetic feet. Sixty female prosthesis users with a lower extremity amputation will be recruited from the Center for the Intrepid (CFI, N=10) and Minneapolis Veterans Affairs (VA) Health Care System (MVAHCS, N=50) during Year 1 of the study. Surveys will be developed and distributed to identify the footwear worn and desired to be worn by females with lower extremity amputations. Participation is not associated with any known risks as all collected data will be completely de-identified. In Year 2, mechanical testing of the identified footwear and prosthetic foot combinations will determine how footwear affects the mechanical properties of the heel, midfoot, and forefoot portions of the foot, as well as its stability.

Women represent a growing portion of the active duty and Veteran populations. Women account for 12% of personnel in recent military conflicts and 10% of the overall Veteran population. As women begin to assume new roles within the military, their rates of traumatic extremity injuries are increasing. The VA serves over 1800 women with amputations, and women are seen more frequently than their male counterparts for rehabilitation services in the VA. The results of this study may have the immediate benefit of guiding prosthetic prescription practices and rehabilitative care at the CFI and MVAHCS, although participants may not receive a direct benefit for study participation. The results of this 2-year study will be rapidly shared with the civilian scientific and medical communities through presentations and publications, and with the Prosthetic and Sensory Aids Service (PSAS) subcommittee of Rehabilitation and Prosthetic Services within the VA. These results may benefit prosthetic prescription and rehabilitative care not only for the seriously injured Service member and Veteran, but also for the thousands of female civilians who undergo an amputation each year.