Self-reported prosthetic sock use among persons with transtibial amputation

Abstract

Study design Cross-sectional survey Background Daily changes in the shape and size of the residual limb affect prosthetic socket fit. Prosthetic socks are often added or removed to manage changes in limb volume. Little has been published about how persons with transtibial amputations use socks to manage diurnal changes in volume and comfort. Objectives To investigate prosthetic sock use with a custom, self-report questionnaire. Methods Persons with transtibial amputation reported number, thickness, and timing of socks used over a 14-day period. Results Data from 23 subjects (16M/7F) were included. On average, socks were changed less than once per day (0.6/day) and ply increased over the day (from 4.8ply to 5.5ply). Subjects wore prostheses significantly longer (15.0hrs and 14.1hrs, p=0.02) and changed socks significantly more often (0.6/day and 0.4/day, p=0.03) on weekdays compared to weekends. Participants were also divided into two subgroups: those who used socks to manage limb volume and those who use socks for socket comfort. Sock use did not differ (p>0.05) between subgroups. Conclusions Sock changes are infrequent among persons with lower limb loss. Initial, verbal reports of sock use were often inconsistent with data measured by logs. Tools (e.g., sock logs or objective instruments) to better understand sock use habits among persons with limb loss are needed.

A Novel Method for Assessing Prosthesis Use and Accommodation Practices of People with Transtibial Amputation

“…did not well characterize prosthesis users' habitual sock use, as reported in a daily log. 8 Prosthesis use data collected in the present study further challenges the notion that clinical behaviors (e.g., reports of sock use) can be accurately obtained via questions posed in a patient interview.…”

“…Thicknesses of socks (socks A-D noted above) worn by the participant for the past 2 weeks were measured under stance phase walking conditions (101.2 kPa) using a custom instrument developed previously. 7 A log to record daily prosthesis donning times, prosthesis doffing times, and sock changes was provided to the participant, 8 and verbal and written instructions were given for how to complete the log. Participants were asked to record in the log the time and sock ply when they first put on their prosthesis during the day and the time and sock ply when they took it off to sleep at night.…”

“…Modifications to the log and instructions may improve accuracy and compliance. The log used in this study was developed previously for monitoring sock use in transtibial prosthesis users, 8 but has not been tested through rigorous qualitative methods such as cognitive interviewing. Cognitive interviewing is often advocated to maximize clarity, comprehension, and quality of survey items and instructions.…”

A finite element model to assess transtibial prosthetic sockets with elastomeric liners

“…Elastomeric liners are in intimate contact with the residual limb while Pelite liners are in intimate contact with the socket wall. This difference is evidenced through patients’ use of prosthetic socks, which are applied to accommodate shape differences between the limb and socket[18, 7]. Prosthetic socks are worn between the limb and liner when using a Pelite liner, and between the liner and socket when using an elastomeric liner.…”

Three-dimensional printing in prosthetics

“…Minor fluctuation in limb volume throughout the day and from day to day are traditionally managed by adding or removing residual limb socks or periodically doffing the prosthesis. [1][2][3][4] Limb volume changes due to long-term trends such as slow physiological changes (e.g. muscle atrophy, steady body mass gain/loss) may result in poor fit due to excessive limb volume loss.…”