Stakeholder perspectives for possible residual limb monitoring system for persons with lower-limb amputation

Abstract

Seven individuals participated in each focus group. Prosthetists came from a mix of practice settings, while prosthesis users were diverse in level of amputation, aetiology, and years of experience using lower-limb prostheses. Residual limb problems reported by participants were consistent with those in the literature. Participants suggested better managing residual limb problems through improved education, better detection of residual limb problems, and using sensor-based information to improve prosthetic technology. Participants favoured short-term use of a possible residual limb monitoring systems to troubleshoot residual limb problems, with temperature and pressure the most frequently mentioned measurements. Participants described that an ideal residual limb monitoring system would be lightweight, not interfere with prosthesis function, and result in benefits with regard to prosthetic care and socket function that outweighed inconveniences or concerns regarding system use. A potential positive of system use included having objective data for reimbursement justification, although it was pointed out that the residual limb monitoring system itself also needed to be reimbursable. Implications for Rehabilitation Stakeholders suggested better managing residual limb problems through improved education, better detection of residual limb problems, and using sensor-based information to improve prosthetic technology. Stakeholders favored short-term use of a possible system to troubleshoot residual limb problems, with temperature and pressure the most frequently mentioned measurements. Stakeholders described that an ideal residual limb monitoring system would be lightweight, not interfere with prosthesis function, and result in benefits with regard to prosthetic care and socket function that outweighs any inconveniences or concerns regarding system use. Stakeholders indicated that a potential positive of system use included having objective data for reimbursement justification, although it was pointed out that the residual limb monitoring system itself also needed to be reimbursable.

Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers

“…There is a general concern that the prosthesis is too heavy to impair the mechanical performance of rehabilitation. 3 Thus, seeking designs and light materials can facilitate creating a prosthesis that more accurately mimics the missing part of the body. However, a concern seems to be different for intraoral prostheses.…”

“…The weight (P) of each prosthesis was estimated based on the formula: P = m * g, in which g is the gravitational acceleration at the point of space where the object of mass m is located. The following formula was used to calculate the mass of each material in each model: m = v * µ, in which v is the volume in cm 3 and µ corresponds to the density in g/cm 3 . The density of the materials was informed based on the literature, and the volume was automatically calculated through the 3D-modeling software.…”

“…Several studies evaluating prosthetic materials report that a light restorative material is advantageous. [1][2][3] A previous study 4 asserted that reinforced composite frameworks seem to be a viable alternative to traditional metal frameworks in implant prosthodontics. The authors also described the lighter framework as an advantage for the treatment.…”

Checklist use for assessment of satisfaction with trans-tibial prostheses

“…The checklist focuses on prosthesis satisfaction and residual limb problems. In assessing residual limb integrity, suggestions have been made regarding residual limb monitoring outside the clinician’s office using sensorbased technology incorporated in the socket to preserve an adequate socket fit and prevent problems ( 13 ). That research was conducted in 2 focus groups; 1 comprising 7 persons with an amputation on trans-tibial and trans-femoral levels with different aetiologies, and the other comprising CPOs with a minimum of 2 years’ experience in prosthesis care.…”

Lower limb prosthetic interfaces

“…In a stakeholder event, participants expressed a preference for a lightweight monitoring system for short-term use that would enable measurement of in-socket temperature and pressure. 155 A potential monitoring system has to be of a minimal disturbance to the user and may initially be considered for a certain group of users, for example, people with vascular disease and older adults.…”