Perception of socket alignment perturbations in amputees with transtibial prostheses

Abstract

Abstract-A person with amputation's subjective perception is the only tool available to describe fit and comfort to a prosthetist. However, few studies have investigated the effect of alignment on this perception. The aim of this article is to determine whether people with amputation could perceive the alignment perturbations of their prostheses and effectively communicate them. A randomized controlled perturbation of angular (3 and 6 degrees) and translational (5 and 10 mm) alignments in the sagittal (flexion, extension, and anterior and posterior translations) and coronal (abduction, adduction, and medial and lateral translations) planes were induced from an aligned condition in 11 subjects with transtibial prostheses. The perception was evaluated when standing (static) and immediately after walking (dynamic) using software that used a visual analog scale under each alignment condition. In the coronal plane, Friedman test demonstrated general statistical differences in static (p < 0.001) and dynamic (p < 0.001) measures of perceptions with angular perturbations. In the sagittal plane, it also demonstrated general statistical differences in late-stance dynamic measures of perceptions (p < 0.001) with angular perturbations, as well as in early-stance dynamic measures of perceptions (p < 0.05) with translational perturbations. Fisher exact test suggested that people with amputation's perceptions were good indicators for coronal angle malalignments but less reliable when defining other alignment conditions.

Prosthetic interventions for people with transtibial amputation: Systematic review and meta-analysis of high-quality prospective literature and systematic reviews

“…None included rater or clinician blinding. Three of the four alignment articles scored 6/10 in terms of methodologic quality, and the highest PEDro score of the alignment articles was 7/10 in one article [25]. Largely because of a lack of concealment and blinding, bias risk was moderate in all of the alignment articles.…”

“…More differences tended to be large, particularly related to measures about the ankle. Nondisabled control subjects (n = 15) were used in one study (2 references) [26][27] to provide a context of so-called normal (i.e., nondisabled) biomechanics, and problematically, only a single female subject is clearly identified to have participated in the experiments related to the alignment topic [25]. Alignment data represent the collective study of 48 subjects Note: Item 1 of PEDro is not included in methodology quality score [20].…”

“…3. Prosthetic component malalignment in the coronal and sagittal planes is detectable by the user when 3°a ngularly or 10 mm linearly [25]. Spatiotemporal and kinetic gait parameters.…”

Effect of stump flexion contracture with and without prosthetic alignment intervention towards postural stability among transtibial prosthesis users

“…Therefore, in this study, the feet opening angle were adjusted according to the standard alignment setting with the agreement from the subjects during alignment adjustment process. This will provide maximum stability to the subjects when using the prosthesis [27].…”

“…OSI is the tilt degree combination for both medial-lateral (ML) and anterior-posterior (AP) axes. This postural balance assessment with different ROM of stump could contribute a vital information in rehabilitation field since stump contracture is one of the biggest issues frequently emerge among the amputees [4,6,27].…”