Socket size adjustments in people with transtibial amputation: Effects on residual limb fluid volume and limb-socket distance.


Journal

Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877

Informations de publication

Date de publication:
03 2019
Historique:
received: 08 09 2018
revised: 27 02 2019
accepted: 28 02 2019
pubmed: 23 3 2019
medline: 24 3 2020
entrez: 23 3 2019
Statut: ppublish

Résumé

Small intermittent adjustments of socket size using adjustable sockets may be a means for people with transtibial amputation to better maintain residual limb fluid volume and limb position while using a prosthesis. Socket size, limb fluid volume, and distance from the limb to the socket, termed "sensed distance," were recorded while participants with transtibial amputation walked on a treadmill wearing a motor-driven, cabled-panel, adjustable socket. Researchers made frequent socket size adjustments using a mobile phone app to identify participants' acceptable socket size range. Limb fluid volume and sensed distance were then monitored as incremental adjustments were made to the socket. Prosthesis users in this study (n = 10) accepted socket sizes between -5% and +5% of their neutral socket volume. There was a rapid increase in limb fluid volume and sensed distance upon socket enlargement, and a rapid decrease upon reduction. Subsequently, there were gradual changes in fluid volume and sensed distance. While visually monitoring limb fluid volume data in real time, researchers were able to adjust socket size to maintain consistent limb fluid volume within a -0.7% to +0.9% volume change for 24 min. Participant residual limbs compensated to socket size adjustment. Using socket-mounted sensors to monitor limb-socket mechanics, an automatic adjustable socket that maintains limb fluid volume may be possible and may improve socket fit in instances where fit deteriorates during use.

Sections du résumé

BACKGROUND
Small intermittent adjustments of socket size using adjustable sockets may be a means for people with transtibial amputation to better maintain residual limb fluid volume and limb position while using a prosthesis.
METHODS
Socket size, limb fluid volume, and distance from the limb to the socket, termed "sensed distance," were recorded while participants with transtibial amputation walked on a treadmill wearing a motor-driven, cabled-panel, adjustable socket. Researchers made frequent socket size adjustments using a mobile phone app to identify participants' acceptable socket size range. Limb fluid volume and sensed distance were then monitored as incremental adjustments were made to the socket.
FINDINGS
Prosthesis users in this study (n = 10) accepted socket sizes between -5% and +5% of their neutral socket volume. There was a rapid increase in limb fluid volume and sensed distance upon socket enlargement, and a rapid decrease upon reduction. Subsequently, there were gradual changes in fluid volume and sensed distance. While visually monitoring limb fluid volume data in real time, researchers were able to adjust socket size to maintain consistent limb fluid volume within a -0.7% to +0.9% volume change for 24 min.
INTERPRETATION
Participant residual limbs compensated to socket size adjustment. Using socket-mounted sensors to monitor limb-socket mechanics, an automatic adjustable socket that maintains limb fluid volume may be possible and may improve socket fit in instances where fit deteriorates during use.

Identifiants

pubmed: 30901641
pii: S0268-0033(18)30745-9
doi: 10.1016/j.clinbiomech.2019.02.022
pii:
doi:

Types de publication

Journal Article Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

161-171

Informations de copyright

Copyright © 2019 Elsevier Ltd. All rights reserved.

Auteurs

Jake B McLean (JB)

Department of Bioengineering, 355061, 3720 15th Ave NE, University of Washington, Seattle, WA 98105, USA.

Christian B Redd (CB)

Department of Bioengineering, 355061, 3720 15th Ave NE, University of Washington, Seattle, WA 98105, USA.

Brian G Larsen (BG)

Department of Bioengineering, 355061, 3720 15th Ave NE, University of Washington, Seattle, WA 98105, USA.

Joseph L Garbini (JL)

Department of Mechanical Engineering, 352600, 3900 E Stevens Way NE, University of Washington, Seattle, WA 98105, USA.

Jacob T Brzostowski (JT)

Department of Bioengineering, 355061, 3720 15th Ave NE, University of Washington, Seattle, WA 98105, USA.

Brian J Hafner (BJ)

Department of Rehabilitation Medicine, 356490, 1959 NE Pacific St, 8th floor North Wing, University of Washington, Seattle, WA 98195, USA.

Joan E Sanders (JE)

Department of Bioengineering, 355061, 3720 15th Ave NE, University of Washington, Seattle, WA 98105, USA. Electronic address: jsanders@uw.edu.

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Classifications MeSH