@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(1):49-55
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(1):49-55
Effect of Fitted Socket Prosthesis on Gait, Performance and Satisfaction Parameters in Below Knee Amputees
ARTICLE INFO
Article Type
Case ReportAuthors
Naseri M. (1 )Kheyri F. (2 )
Nabavi H. (3 )
Safari M.R. (* )
(* ) Orthotics and Prosthetics Department, Rehabilitation Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
(1 ) Orthotics and Prosthetics Department, Rehabilitation Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
(2 ) Omid Technical Orthopedic Clinic, Tehran, Iran
(3 ) Ergonomics Department, Rehabilitation Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Correspondence
Article History
Received: October 27, 2014Accepted: December 22, 2014
ePublished: February 19, 2015
ABSTRACT
Aims
Amputation of the lower limbs may lead to physical, psychological and physiological
changes in amputated person. This study aimed to investigate the relationship between
prosthetic socket status and walking characteristics, the performance and satisfaction of
below knee amputates.
Materials & Methods This study was done from the beginning of October to mid-January 2013 at the Red Crescent Society and the University of Social Welfare and Rehabilitation. Samples were selected using convenient sampling. To evaluate the amputee’s performance, comfort and satisfaction were measured by Trinity Amputation and Prosthesis Experience Scales and Socket Comfort Score scale. The final analysis of the data was performed using SPSS 19 software and non-parametric Wilcoxon test to compare two related samples in repeated measurements.
Findings Satisfaction with the fitted socket prosthesis was 28.5±1.98 and non-fitted was 22.66±3.55 (p=0.026). Performance restriction using fitted socket prosthesis was 2.50± 2.07, and using non-fitted socket prosthesis was 8.33±1.86 (p=0.024). Psychosocial adaptation using fitted socket prosthesis was 1505±5.16 and using non-fitted socket prosthesis was 14.33±4.08 which was not significantly different (p=0.5). The difference between convenience of amputee using fitted socket prosthesis (8.16±0.75) and non-fitted socket prosthesis (5.23±0.82) was significant (p=0.026).
Conclusion There is a direct relationship between patient’s feeling comfortable during gaiting and convenience and fitting of prosthetic socket, but there is no relationship between spatial-temporal parameters and speed of walking, except maximum knee folding asymmetry index in the static phase.
Materials & Methods This study was done from the beginning of October to mid-January 2013 at the Red Crescent Society and the University of Social Welfare and Rehabilitation. Samples were selected using convenient sampling. To evaluate the amputee’s performance, comfort and satisfaction were measured by Trinity Amputation and Prosthesis Experience Scales and Socket Comfort Score scale. The final analysis of the data was performed using SPSS 19 software and non-parametric Wilcoxon test to compare two related samples in repeated measurements.
Findings Satisfaction with the fitted socket prosthesis was 28.5±1.98 and non-fitted was 22.66±3.55 (p=0.026). Performance restriction using fitted socket prosthesis was 2.50± 2.07, and using non-fitted socket prosthesis was 8.33±1.86 (p=0.024). Psychosocial adaptation using fitted socket prosthesis was 1505±5.16 and using non-fitted socket prosthesis was 14.33±4.08 which was not significantly different (p=0.5). The difference between convenience of amputee using fitted socket prosthesis (8.16±0.75) and non-fitted socket prosthesis (5.23±0.82) was significant (p=0.026).
Conclusion There is a direct relationship between patient’s feeling comfortable during gaiting and convenience and fitting of prosthetic socket, but there is no relationship between spatial-temporal parameters and speed of walking, except maximum knee folding asymmetry index in the static phase.
CITATION LINKS
[1]Breakey JW. Body image: The lower-limb amputee. JPO J Prosthet Orthot. 1997;9(2):58-66.
[2]Shahriar Sh. Training booklet for physicians’ health monitoring (particularly on lower limbamputee’s veterans). Department of Veterans Affairs Health Care Foundation; 2011. Available from: http://www.isaarsci.ir/PHYSICIAN%20folder/physcicianarticle/physician%20ebook/sciebook11.pdf. [Persian]
[3]Schmalz T, Blumentritt S, Jarasch R. Energy expenditure and biomechanical characteristics of lower limb amputee gait: The influence of prosthetic alignment and different prosthetic components. Gait Posture. 2002;16(3):255-63.
[4]Board W, Street G, Caspers C. A comparison of trans-tibial amputee suction and vacuum socket conditions. Prosthet Orthot Int. 2001;25(3):202-9.
[5]Fergason J, Smith DG. Socket Considerations for the Patient With a Transtibial Amputation. Clin Orthop Relat Res. 1999;(361):76-84.
[6]Aström I, Stenström A. Effect on gait and socket comfort in unilateral trans-tibial amputees after exchange to a polyurethane concept. Prosthet Orthot Int. 2004;28(1):28-36.
[7]Legro MW, Reiber G, del Aguila M, Ajax MJ, Boone DA, Larsen JA, et al. Issues of importance reported by persons with lower limb amputations and prostheses. J Rehabil Res Dev. 1999;36(3):155-63.
[8]Pell JP, Donnan PT, Fowkes FG, Ruckley CV. Quality of life following lower limb amputation for peripheral arterial disease. Eur J Vasc Surg. 1993;7(4):448-51.
[9]Sanders JE, Zachariah SG, Baker AB, Greve JM, Clinton C. Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees. Clin Biomech (Bristol, Avon). 2000;15(9):684-94.
[10]Sanders JE, Fatone S. Residual limb volume change: Systematic review of measurement and management. J Rehabil Res Dev. 2011;48(8):949-86.
[11]Sanders J, Zachariah S, Jacobsen A, Fergason J. Changes in interface pressures and shear stresses over time on trans-tibial amputee subjects ambulating with prosthetic limbs: comparison of diurnal and six-month differences. J Biomech. 2005;38(8):1566-73.
[12]Zahedi M, Spence W, Solomonidis S, Paul J. Alignment of lower-limb prostheses. J Rehabil Res Dev. 1986;23(2):2-19.
[13]Jia X, Zhang M, Lee WC. Load transfer mechanics between trans-tibial prosthetic socket and residual limb—dynamic effects. J Biomech. 2004;37(9):1371-7.
[14]Selles R, Bussmann J, Van Soest AJ, Stam H. The effect of prosthetic mass properties on the gait of transtibial amputees-a mathematical model. Disabil Rehabil. 2004;26(12):694-704.
[15]Seelen H, Anemaat S, Janssen H, Deckers J. Effects of prosthesis alignment on pressure distribution at the stump/socket interface in transtibial amputees during unsupported stance and gait. Clin Rehabil. 2003;17(7):787-96.
[16]Sanderson DJ, Martin PE. Lower extremity kinematic and kinetic adaptations in unilateral below-knee amputees during walking. Gait Posture. 1997;6(2):126-36.
[17]Barth DG, Schumacher L, Thomas SS. Gait analysis and energy cost of below-knee amputees wearing six different prosthetic feet. JPO J Prosthet Orthot. 1992;4(2):63-75.
[18]Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Arch Phys Med Rehabil. 2006;87(10):1334-9.
[19]Ventura JD, Klute GK, Neptune RR. The effects of prosthetic ankle dorsiflexion and energy return on below-knee amputee leg loading. Clin Biomech. 2011;26(3):298-303.
[20]Torburn L, Powers CM, Guiterrez R, Perry J. Energy expenditure during ambulation in dysvascular and traumatic below-knee amputees: A comparison of five prosthetic feet. J Rehabil Res Dev. 1995;32(2):111-9.
[21]Sanders JE, Lain D, Dralle AJ, Okumura R. Interface pressures and shear stresses at thirteen socket sites on two persons with transtibial amputation. J Rehabil Res Dev. 1997;34(1):19-43.
[22]Sanders JE, Daly CH. Normal and shear stresses on a residual limb in a prosthetic socket during ambulation: comparison of finite element results with experimental measurements. J Rehabil Res Dev. 1993;30(2):191-204.
[23]Sewell P, Noroozi S, Vinney J, Andrews S. Developments in the trans-tibial prosthetic socket fitting process: a review of past and present research. Prosthet Orthot Int. 2000;24(2):97-107.
[24]Wolf SI, Alimusaj M, Fradet L, Siegel J, Braatz F. Pressure characteristics at the stump/socket interface in transtibial amputees using an adaptive prosthetic foot. Clin Biomech. 2009;24(10):860-5.
[25]Gallagher P, MacLachlan M. Development and psychometric evaluation of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Rehabil Psychol. 2000;45(2):130-54.
[26]Desmond DM, MacLachlan M. Factor structure of the Trinity Amputation and Prosthesis Experience Scales (TAPES) with individuals with acquired upper limb amputations. Am J Phys Med Rehabil. 2005;84(7):506-13.
[27]Fardipour S, Salvati M, Bahramizadeh M, Hadadi M, Mazaheri M. Cross-cultural adaptation and evaluation of validity and reliability of Trinity amputation and prosthesis experience scales in an Iranian people with lower limb amputation. Koomesh. 2011;12(4):413-8.
[28]Hanspal RS, Fisher K, Nieveen R. Prosthetic socket fit comfort score. Disabil Rehabil. 2003;25(22):1278-80.
[29]Assi A, Ghanem I, Lavaste F, Skalli W. Gait analysis in children and uncertainty assessment for Davis protocol and Gillette Gait Index. Gait Posture. 2009;30(1):22-6.
[30]Davis III RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Human Move Sci. 1991;10(5):575-87.
[31]Torburn L, Perry J, Ayyappa E, Shanfield SL. Below-knee amputee gait with dynamic elastic response prosthetic feet: A pilot study. J Rehabil Res Dev. 1990;27(4):369-84.
[32]van der Linde H, Hofstad CJ, Geurts AC, Postema K, Geertzen JH, van Limbeek J. A systematic literature review of the effect of different prosthetic components on human functioning with a lower-limb prosthesis. J Rehabil Res Dev. 2004;41(4):555-70.
[33]Soares AS, Yamaguti EY, Mochizuki L, Amadio AC, Serrão JC. Biomechanical parameters of gait among transtibial amputees: A review. Sao Paulo Med J. 2009;127(5):302-9.
[34]Fang L, Jia X, Wang R. Modeling and simulation of muscle forces of trans-tibial amputee to study effect of prosthetic alignment. Clin Biomech. 2007;22(10):1125-31
[35]Macfarlane PA, Nielsen DH, Shurr DG, Meier K. Gait Comparisons for Below-Knee Amputees Using a Flex-FootTM] Versus a Conventional Prosthetic Foot. JPO J Prosthet Orthot. 1991;3(4):150-61.
[36]Schmid M, Beltrami G, Zambarbieri D, Verni G. Centre of pressure displacements in trans-femoral amputees during gait. Gait Posture. 2005;21(3):255-62.
[37]Hof AL, van Bockel RM, Schoppen T, Postema K. Control of lateral balance in walking: experimental findings in normal subjects and above-knee amputees. Gait Posture. 2007;25(2):250-8.
[38]Isakov E, Mizrahi J, Susak Z, Ona I, Hakim N. Influence of prosthesis alignment on the standing balance of below-knee amputees. Clin Biomech. 1994;9(4):258-62
[39]Lamoth CJ, Ainsworth E, Polomski W, Houdijk H. Variability and stability analysis of walking of transfemoral amputees. Med Eng Phys. 2010;32(9):1009-14.
[2]Shahriar Sh. Training booklet for physicians’ health monitoring (particularly on lower limbamputee’s veterans). Department of Veterans Affairs Health Care Foundation; 2011. Available from: http://www.isaarsci.ir/PHYSICIAN%20folder/physcicianarticle/physician%20ebook/sciebook11.pdf. [Persian]
[3]Schmalz T, Blumentritt S, Jarasch R. Energy expenditure and biomechanical characteristics of lower limb amputee gait: The influence of prosthetic alignment and different prosthetic components. Gait Posture. 2002;16(3):255-63.
[4]Board W, Street G, Caspers C. A comparison of trans-tibial amputee suction and vacuum socket conditions. Prosthet Orthot Int. 2001;25(3):202-9.
[5]Fergason J, Smith DG. Socket Considerations for the Patient With a Transtibial Amputation. Clin Orthop Relat Res. 1999;(361):76-84.
[6]Aström I, Stenström A. Effect on gait and socket comfort in unilateral trans-tibial amputees after exchange to a polyurethane concept. Prosthet Orthot Int. 2004;28(1):28-36.
[7]Legro MW, Reiber G, del Aguila M, Ajax MJ, Boone DA, Larsen JA, et al. Issues of importance reported by persons with lower limb amputations and prostheses. J Rehabil Res Dev. 1999;36(3):155-63.
[8]Pell JP, Donnan PT, Fowkes FG, Ruckley CV. Quality of life following lower limb amputation for peripheral arterial disease. Eur J Vasc Surg. 1993;7(4):448-51.
[9]Sanders JE, Zachariah SG, Baker AB, Greve JM, Clinton C. Effects of changes in cadence, prosthetic componentry, and time on interface pressures and shear stresses of three trans-tibial amputees. Clin Biomech (Bristol, Avon). 2000;15(9):684-94.
[10]Sanders JE, Fatone S. Residual limb volume change: Systematic review of measurement and management. J Rehabil Res Dev. 2011;48(8):949-86.
[11]Sanders J, Zachariah S, Jacobsen A, Fergason J. Changes in interface pressures and shear stresses over time on trans-tibial amputee subjects ambulating with prosthetic limbs: comparison of diurnal and six-month differences. J Biomech. 2005;38(8):1566-73.
[12]Zahedi M, Spence W, Solomonidis S, Paul J. Alignment of lower-limb prostheses. J Rehabil Res Dev. 1986;23(2):2-19.
[13]Jia X, Zhang M, Lee WC. Load transfer mechanics between trans-tibial prosthetic socket and residual limb—dynamic effects. J Biomech. 2004;37(9):1371-7.
[14]Selles R, Bussmann J, Van Soest AJ, Stam H. The effect of prosthetic mass properties on the gait of transtibial amputees-a mathematical model. Disabil Rehabil. 2004;26(12):694-704.
[15]Seelen H, Anemaat S, Janssen H, Deckers J. Effects of prosthesis alignment on pressure distribution at the stump/socket interface in transtibial amputees during unsupported stance and gait. Clin Rehabil. 2003;17(7):787-96.
[16]Sanderson DJ, Martin PE. Lower extremity kinematic and kinetic adaptations in unilateral below-knee amputees during walking. Gait Posture. 1997;6(2):126-36.
[17]Barth DG, Schumacher L, Thomas SS. Gait analysis and energy cost of below-knee amputees wearing six different prosthetic feet. JPO J Prosthet Orthot. 1992;4(2):63-75.
[18]Zmitrewicz RJ, Neptune RR, Walden JG, Rogers WE, Bosker GW. The effect of foot and ankle prosthetic components on braking and propulsive impulses during transtibial amputee gait. Arch Phys Med Rehabil. 2006;87(10):1334-9.
[19]Ventura JD, Klute GK, Neptune RR. The effects of prosthetic ankle dorsiflexion and energy return on below-knee amputee leg loading. Clin Biomech. 2011;26(3):298-303.
[20]Torburn L, Powers CM, Guiterrez R, Perry J. Energy expenditure during ambulation in dysvascular and traumatic below-knee amputees: A comparison of five prosthetic feet. J Rehabil Res Dev. 1995;32(2):111-9.
[21]Sanders JE, Lain D, Dralle AJ, Okumura R. Interface pressures and shear stresses at thirteen socket sites on two persons with transtibial amputation. J Rehabil Res Dev. 1997;34(1):19-43.
[22]Sanders JE, Daly CH. Normal and shear stresses on a residual limb in a prosthetic socket during ambulation: comparison of finite element results with experimental measurements. J Rehabil Res Dev. 1993;30(2):191-204.
[23]Sewell P, Noroozi S, Vinney J, Andrews S. Developments in the trans-tibial prosthetic socket fitting process: a review of past and present research. Prosthet Orthot Int. 2000;24(2):97-107.
[24]Wolf SI, Alimusaj M, Fradet L, Siegel J, Braatz F. Pressure characteristics at the stump/socket interface in transtibial amputees using an adaptive prosthetic foot. Clin Biomech. 2009;24(10):860-5.
[25]Gallagher P, MacLachlan M. Development and psychometric evaluation of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Rehabil Psychol. 2000;45(2):130-54.
[26]Desmond DM, MacLachlan M. Factor structure of the Trinity Amputation and Prosthesis Experience Scales (TAPES) with individuals with acquired upper limb amputations. Am J Phys Med Rehabil. 2005;84(7):506-13.
[27]Fardipour S, Salvati M, Bahramizadeh M, Hadadi M, Mazaheri M. Cross-cultural adaptation and evaluation of validity and reliability of Trinity amputation and prosthesis experience scales in an Iranian people with lower limb amputation. Koomesh. 2011;12(4):413-8.
[28]Hanspal RS, Fisher K, Nieveen R. Prosthetic socket fit comfort score. Disabil Rehabil. 2003;25(22):1278-80.
[29]Assi A, Ghanem I, Lavaste F, Skalli W. Gait analysis in children and uncertainty assessment for Davis protocol and Gillette Gait Index. Gait Posture. 2009;30(1):22-6.
[30]Davis III RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Human Move Sci. 1991;10(5):575-87.
[31]Torburn L, Perry J, Ayyappa E, Shanfield SL. Below-knee amputee gait with dynamic elastic response prosthetic feet: A pilot study. J Rehabil Res Dev. 1990;27(4):369-84.
[32]van der Linde H, Hofstad CJ, Geurts AC, Postema K, Geertzen JH, van Limbeek J. A systematic literature review of the effect of different prosthetic components on human functioning with a lower-limb prosthesis. J Rehabil Res Dev. 2004;41(4):555-70.
[33]Soares AS, Yamaguti EY, Mochizuki L, Amadio AC, Serrão JC. Biomechanical parameters of gait among transtibial amputees: A review. Sao Paulo Med J. 2009;127(5):302-9.
[34]Fang L, Jia X, Wang R. Modeling and simulation of muscle forces of trans-tibial amputee to study effect of prosthetic alignment. Clin Biomech. 2007;22(10):1125-31
[35]Macfarlane PA, Nielsen DH, Shurr DG, Meier K. Gait Comparisons for Below-Knee Amputees Using a Flex-FootTM] Versus a Conventional Prosthetic Foot. JPO J Prosthet Orthot. 1991;3(4):150-61.
[36]Schmid M, Beltrami G, Zambarbieri D, Verni G. Centre of pressure displacements in trans-femoral amputees during gait. Gait Posture. 2005;21(3):255-62.
[37]Hof AL, van Bockel RM, Schoppen T, Postema K. Control of lateral balance in walking: experimental findings in normal subjects and above-knee amputees. Gait Posture. 2007;25(2):250-8.
[38]Isakov E, Mizrahi J, Susak Z, Ona I, Hakim N. Influence of prosthesis alignment on the standing balance of below-knee amputees. Clin Biomech. 1994;9(4):258-62
[39]Lamoth CJ, Ainsworth E, Polomski W, Houdijk H. Variability and stability analysis of walking of transfemoral amputees. Med Eng Phys. 2010;32(9):1009-14.