Vacuum-Assisted Socket Suspension Compared With Pin Suspension for Lower Extremity Amputees: Effect on Fit, Activity, and Limb Volume

Klute, Glenn K.; Berge, Jocelyn S.; Biggs, Wayne; Pongnumkul, Suporn; Popović, Zoran; Curless, Brian

doi:10.1016/j.apmr.2011.05.019

Cited by 116 publications

(172 citation statements)

References 16 publications

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“…The area that is then used to achieve VAS is also used to achieve the connection to the socket through the reflective sealing component (Figure 2). In a sample of people with transtibial amputation, Klute et al observed a reduction in pistoning from 6 mm with pin suspension to 1 mm with VAS [10]. They concluded that VAS could result in a superior fitting socket because it minimizes pistoning.…”

Section: Discussionmentioning

confidence: 99%

“…The benefits of dynamic VAS may provide the person with amputation with improved socket pressure distribution, daily volume management, rotational control, musculoskeletal stability, and reduced socket movement [9][10][12][13]. If VAS does favorably affect these variables for the TFA, then the IRC brim's purpose may be biomechanically diminished.…”

Section: Introductionmentioning

confidence: 99%

“…This dynamic suspension may provide a more positive link to the prosthesis and reduce prosthetic migration and socket movement (pistoning and lateral shifting) during gait and other activities such as sitting [9][10]. Reduced motion could increase control in swing and stance by establishing a more stable and healthy environment for the femur and thigh [9][10][11]. Because of new silicone liner and vacuum pump technology, maintaining VAS as a form of suspension has recently become an option for the person with TFA.…”

Section: Introductionmentioning

confidence: 99%

“…Enhanced suspension creates a more solid connection to the socket, which potentially creates less motion during swing, resulting in the perception of greater control and less prosthetic weight for the person with amputation [9][10]. Vacuum-assisted suspension (VAS) offers the person with amputation a dynamic form of suspension in that it can actively suspend through a manual or electronic pump.…”

Section: Introductionmentioning

confidence: 99%

“…Vacuum-assisted suspension (VAS) offers the person with amputation a dynamic form of suspension in that it can actively suspend through a manual or electronic pump. This dynamic suspension may provide a more positive link to the prosthesis and reduce prosthetic migration and socket movement (pistoning and lateral shifting) during gait and other activities such as sitting [9][10]. Reduced motion could increase control in swing and stance by establishing a more stable and healthy environment for the femur and thigh [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

Kahle

Highsmith²

2013

J Rehabil Res Dev

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Abstract-The objective of this study was to investigate the effect of brimless compared with ischial ramus containment (IRC) prosthetic sockets when using vacuum-assisted suspension (VAS) on persons with a unilateral transfemoral amputation (TFA). A randomized crossover design with a 2 d accommodation was used. People with unilateral TFA (n = 9 analyzed) were enrolled. Interventions were IRC VAS and brimless VAS sockets. Main outcome measures included coronal hip angle and vertical and lateral socket movement as measured by X-ray, skin pressure measured by Tekscan, and preference measured subjectively. The brimless design was statistically equivalent to IRC in all measured coronal hip angles and vertical and lateral socket displacement. The peak/stance mean pressure in the medial proximal aspect of the socket was 322 mmHg in the IRC compared with 190 mmHg in the brimless condition. Except for medial proximal pressure, no other measures reached statistical significance. All subjects reported the brimless design to be more comfortable than the IRC in short-term preference. Brimless VAS socket design may be a clinically viable choice for people with TFA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

Kahle

Highsmith²

2013

J Rehabil Res Dev

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Fluid Volume Management in Prosthesis Users: Augmenting Panel Release with Pin Release

McLean

Larsen

Weathersby

et al. 2020

PM&R

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Background: Management of fluid in the limbs is a challenge faced by people with disabilities. In prosthetics, a means for transtibial prosthesis users to stabilize their residual limb fluid volume during the day may improve socket fit. Objective: To determine if releasing the panels and locking pin of a cabled-panel adjustable socket during socket release significantly improved limb fluid volume recovery and retention over releasing the panels alone. Design: Repeated-measures experiment to assess the effects on limb fluid volume retention. Setting: Participants were tested in a laboratory setting while walking on a treadmill. Intervention: Release of a locking pin tether during sitting as a limb volume accommodation strategy. Main Outcome Measure: Percent limb fluid volume retention for panel and pin release compared with panel release alone at 2 minutes (short term) and 50 minutes (long term) after subsequent activity. Limb fluid volume was monitored using bioimpedance analysis. Results: Median percent limb fluid volume retention for the panel and pin release was significantly greater than panel release alone for both anterior and posterior regions for the long term (P = .0499 and .0096, respectively) but not the short term (P = .0712 and .1580, respectively). Conclusion: Augmenting panel release with pin release may be an effective accommodation strategy for prosthesis users with transtibial amputation to better retain limb fluid volume.

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The relationship between residual limb health, motion within the socket, and prosthetic suspension

Baumann

Price

Brousseau

et al. 2022

PM&R

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Residual limb health is critical for continued prosthesis use; however, many prosthesis users experience skin‐related breakdown. The interface between the residual limb and the prosthetic socket sets the local mechanical environment and plays a role in skin stresses. Motion of the residual limb in the socket adds additional mechanical strain on the limb. This article explores the relationship between motion of the limb in the socket and residual limb health. We evaluated current methods for assessing residual limb health and motion of the residual limb in the socket and compared these evaluations across different prosthetic suspension systems. While few direct studies comparing residual limb health and motion exist, it has been shown that elevated vacuum suspension systems result in both improved residual limb health compared to passive suction and pin‐lock systems and decreased motion compared to passive suction, pin‐lock, knee sleeve, and anatomical suspension systems. While motion and health have not been directly linked, elevated vacuum suspension may demonstrate a relationship that reduced motion of the residual limb in the socket improves residual limb health. Further evaluation in this area is necessary to more completely and directly understand the relationship between residual limb motion and residual limb health.

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Vacuum-Assisted Socket Suspension Compared With Pin Suspension for Lower Extremity Amputees: Effect on Fit, Activity, and Limb Volume

Cited by 116 publications

References 16 publications

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

Fluid Volume Management in Prosthesis Users: Augmenting Panel Release with Pin Release

The relationship between residual limb health, motion within the socket, and prosthetic suspension

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