Vibrotactile evaluation: Osseointegrated versus socket-suspended transfemoral prostheses

Abstract

Abstract-This study investigated detection thresholds of vibrometric stimuli in patients with transfemoral amputation supplied with osseointegrated (OI) and socket-suspended prostheses. It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17) using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8,16,32, 64, 125, and 250 Hz). Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis. The results showed that the OI group had improved ability to detect vibrations through the prosthesis at 125 Hz (p = 0.01) at follow-up compared with the preoperative measurement. Compared with the control group, the OI group at follow-up had better ability to detect high frequency vibrations through the prosthesis (125 Hz, p = 0.02; 250 Hz, p = 0.03). The vibrometric signal transmitted through the test prosthesis was reduced at 8, 125, and 250 Hz but was amplified at 16, 32, and 64 Hz. Differences between the OI and the control groups were found in the highest frequencies in which the test prosthesis showed reduction of the vibrometric signal. The study provides insight into the mechanisms of vibration transmission between the exterior and bone-anchored as well as socketsuspended amputation prostheses.

Long-term outcomes following lower extremity press-fit bone-anchored prosthesis surgery: a 5-year longitudinal study protocol

“…An advantage of direct attachment to the bone, regardless of the used BAP method, is that the patient has a better ability to detect vibrotactile and pressure stimuli of the prosthetic limb compared to socket prosthesis users [22, 37, 38]. These stimuli are also known as osseoperception.…”

The role of tactile afference in shaping motor behaviour and implications for prosthetic innovation

“…A further study found a similar result using vibration, but additionally found that detection thresholds in osseointegrated prostheses were better for higher frequencies ( 4100 Hz) (Häggström et al, 2013). Clinical observations have also found that patients can feel and judge mechanical loadings through osseointegrated prosthetics (Häggström et al, 2013).…”

“…Although the thresholds for detection were increased for both types of prosthesis, the osseointegrated prosthesis gave better detection thresholds than the socket-anchored prosthesis (Jacobs et al, 2000). A further study found a similar result using vibration, but additionally found that detection thresholds in osseointegrated prostheses were better for higher frequencies ( 4100 Hz) (Häggström et al, 2013). Clinical observations have also found that patients can feel and judge mechanical loadings through osseointegrated prosthetics (Häggström et al, 2013).…”

Gait rehabilitation for a patient with an osseointegrated prosthesis following transfemoral amputation

“…Cadence, duration of the gait cycle, and duration of the support phase of BAP users are also more similar to those of able-bodied persons than of SP users (Frossard et al, 2010b). A further advantage of BAP is the improved sensory feedback, known as osseoperception, resulting from the direct link between the prosthesis and skeletal system (Aschoff, Clausen, Tsoumpris, and Hoffmeister, 2011;Branemark, Branemark, Rydevik, and Myers, 2001;Haggstrom, Hagberg, Rydevik, and Branemark, 2013;Sullivan, Uden, Robinson, and Sooriakumaran, 2003). OPRA rehabilitation has been extensively described, but there are few descriptions of rehabilitation for patients with EEFP in the peerreviewed literature (Aschoff, Clausen, Tsoumpris, and Hoffmeister, 2011;Hagberg and Branemark, 2009;Van de Meent, Hopman, and Frolke, 2013).…”