In learning to walk up and down stairs with bilateral prostheses, which prosthesis should lead when ascending and which when descending?

• A. Transtibial prosthesis when ascending and descending
• B. Transfemoral prosthesis when ascending and descending
• C. Transtibial prosthesis when ascending, and the transfemoral prosthesis when descending
• D. Transfemoral prosthesis when ascending, and the transtibial prosthesis when descending

Answer: (C)

When negotiating stairs with two prostheses of different levels, use the limb that can most effectively control and lift the body for each phase. The transtibial prosthesis should lead when ascending because it provides a strong, stable push using the wearer’s intact knee and hip mechanics to lift the body up to the next step. The transfemoral prosthesis should lead when descending because its artificial knee can regulate knee flexion and provide controlled lowering, allowing you to place the next step down safely while the other leg follows. This pattern leverages the TT limb’s capacity to drive ascent and the TF limb’s knee control to manage descent.