Ten studies with 102 patients were included: 6 RCTs (57 patients), 1 non-randomised trial (4 patients), 1 retrospective study (39 patients) and 2 single case studies. TF amputees were studied in 5 experimental studies (36 patients); TTA in 2 experimental, 1 retrospective and 1 single case study (65 patients); and TK amputees studied in 1 single case study (1 patient).
The methods of most of the experimental studies were relatively poor. Of the 7 experimental studies, 5 used uniform prosthetic components in all patients and 6 performed statistical analysis. Only 4 experimental studies scored positive on all validity criteria, and most studies involved a small (10 or less) number of patients.
Effects of prosthetic mass on economy of prosthetic gait (5 studieswith 76 patients, including 3 RCTs with 33 patients): 4 studies, including the 3 RCTs, reported similar non significant effects on economy after the addition of loads ranging from 0.454 to 3.5 kg, compared to the unloaded state. One non-randomised trial (4 patients) reported a significant effect of loading on economy with minimal energy use with loading of 1.70 kg, compared to heavier loads.
Effects of prosthetic mass on gait pattern (7 studies with 83patients, including 5 RCTs with 78 patients): no significant effect of prosthetic loading was noted in any of the studies for SSWS, SL or SF.
Effects of prosthetic centre of mass on economy of prosthetic gait (2 studies with 19 patients, including 1 RCT): one RCT (15 patients) reported significant decreases in economy when the centre of mass was distal compared to proximal. The other study also found a significant effect of the location of prosthetic mass: the two intermediate mass locations, i.e. 17 and 25 cm distal to the knee, were found to be most energy efficient.
Effects of prosthetic centre of mass on gait pattern (2 studies with16 patients, including 1 RCT with 15 patients): no significant effect was found in either study.