Journal of Prosthetics and Orthotics最新文献

{"title":"Kinetic and Kinematics Parameters of Hip in Gait for a Congenital Longitudinal Tibial Deficiency with Orthoprosthesis and Transfemoral Prosthesis: A Case Study","authors":"S. Alsancak, S. Güner, I. C. Tuncay","doi":"10.1097/JPO.0000000000000385","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000385","url":null,"abstract":"ABSTRACT Introduction Congenital longitudinal tibial deficiency is a rare condition. It is characterized by partial or complete absence of tibia with a relatively intact fibula. Its standard treatment is surgery and employing orthoprosthesis or prosthesis. However, the effects of gaits according to the types of prosthesis is barely known. Methods Orthoprosthesis is offered to a 30-year-old man experiencing left-side congenital type 1 tibial hemimelia (classified as Jones type 1B) deficiency with thoracolumbar scoliosis and exhibiting a depressed shoulder as well as a stiff knee. He decided to have an amputation to wear a transfemoral (TF) prosthesis comprising a microprocessor-controlled knee. Results Three-dimensional gait analyses and a 6-minute walk test were performed preoperatively and postoperatively with the orthoprosthesis and TF prosthesis. Furthermore, the kinematics of hip flexion/extension and pelvic anterior/posterior tilt range of the motion degree were increased using TF prosthesis. The result of the kinetics of the hip flexion/extension moment and hip power parameters were affected using the TF prosthesis. Conclusions This case study suggests that the new prosthesis provides removable and adaptable component; further, it delivers a comfortable sitting experience because of its new socket design and knee joint flexion. Clinical Relevance Patient satisfaction is better with TF prosthesis than with orthoprosthesis. TF prosthesis is more cosmetic than orthoprosthesis, provides a symmetrical gait pattern, decreases donning and doffing durations, and there is no uncomfortable protrusion when sitting (due to amputation of the foot and leg part).","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"33 1","pages":"304 - 310"},"PeriodicalIF":0.6,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44300665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long-Term Wearing of Foot Orthoses Can Change the Frequency Domain of Ground Reaction Forces in Children with Flexible Flat Feet","authors":"A. Jafarnezhadgero, Seyed Hamed Musavi, Seyed Majid Alavi Mehr, Morteza Madadi-Shad","doi":"10.1097/JPO.0000000000000386","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000386","url":null,"abstract":"ABSTRACT Introduction Analyzing the frequency content of ground reaction forces (GRFs) might be helpful when assessing gait abnormalities in children with flexible flatfeet. The aims of this study were therefore to evaluate 1) differences in GRF frequency content between children with and without flatfeet; and 2) whether the long-term wearing of foot orthoses changes the GRF frequency contents in children with flatfeet. Materials and Methods This is a pre-post study design. GRFs were collected at baseline for boys both with and without flatfeet. Boys with flatfeet wore custom-made foot orthoses with unique shoes for 4 months; GRFs were collected for the flatfeet group after 4 months too. Data were collected while participants wore shoes without foot orthoses in the pretest and shoes with foot orthoses in the posttest. GRFs were collected during walking by two Kistler force platforms (each force plate was used for each leg). Multivariate analysis of variance (MANOVA) test and a separate 2 (side: dominant vs. nondominant) × 2 (time: pretest vs. posttest) ANOVA with repeated measures were used for statistical analysis. Results The flatfeet group indicated lower vertical GRF frequency (P = 0.003; d = 1.21; 95% confidence interval [CI], 7.12–7.59) and greater vertical amplitude of harmonic 16 for the nondominant limb (P = 0.030; d = 0.71; 95% CI, 0.0001–0.0022) than the normal feet group. No significant differences in GRF frequency content were found for the dominant limb between pretest and posttest (P > 0.05; d = 0.01–039). However, for nondominant limb, vertical GRF frequency content (P < 0.001; d = 0.85; 95% CI, 6.21–7.36) was diminished at posttest compared with pretest. In the nondominant limb, the anteroposterior GRF frequency with a power of 99.5% showed a significant increase at posttest compared with pretest (P = 0.025; d = 0.50; 95% CI, 13.30–16.20). For both limbs, amplitudes of three-dimensional GRF components were lower at posttest than at pretest (P < 0.05; d = 0.0.14–1.20; 95% CI, −0.0005 to −0.0083). Conclusions The results indicated lower GRF frequency content and amplitudes after long-term wearing of foot orthoses. Therefore, long-term wearing of foot orthoses may be applied to obtain functional improvements in children with flatfeet. Clinical Relevance Clinicians are advised to apply foot orthoses to improve functions in children with flatfeet.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"22 - 32"},"PeriodicalIF":0.6,"publicationDate":"2021-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43754798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Spinal Orthoses on Immobilizing the Cervical Spine: A Systematic Review of Research Methodologies","authors":"N. Eddison, S. Benyahia, N. Chockalingam","doi":"10.1097/JPO.0000000000000382","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000382","url":null,"abstract":"ABSTRACT Introduction The purpose of this article is to review the literature on the effect of immobilization of the cervical spine using orthotic devices. The review focused on the methodologies of the studies to see if this might be a contributing factor to the lack of available clinical guidelines on spinal immobilization using orthoses. Methods This review was conducted using PRISMA guidelines (PLoS Med. 2009;6:e1000097). The search was conducted in August 2019 within all major databases using relevant phrases. No date restrictions were applied, but the search was restricted to full manuscripts published in English. These searches were then supplemented by tracking all key references from the appropriate articles identified. Articles were selected according to a priori–defined criteria. Initially, data were extracted regarding publication details, orthosis name and group, spinal level studied, and whether cervical range of motion was measured. Results A total of 52 articles fulfilled the inclusion criteria. This article discusses the methodology of the included studies. Conclusions There is a clear paucity of well-designed research on immobilization of the cervical spine using orthotic devices. Comparing the results of studies using different types of orthoses is difficult due to the type and age of the participants involved (healthy, pathological, cadaver) and the different techniques of measurement used. This lack of standardization prevents meta-analyses from being performed and may be a contributing factor to the lack of available clinical guidelines. An agreed structured methodology is required to enable meta-analyses and determine clinical guidelines for the prescription of spinal orthoses for cervical spine pathology.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"e93 - e98"},"PeriodicalIF":0.6,"publicationDate":"2021-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41877255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobility Analysis of AmpuTees (MAAT 6): Mobility, Satisfaction, and Quality of Life among Long-Term Dysvascular/Diabetic Prosthesis Users-Results of a Cross-Sectional Analysis.","authors":"Shane R Wurdeman,&nbsp;Phillip M Stevens,&nbsp;James H Campbell","doi":"10.1097/JPO.0000000000000304","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000304","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to establish the mobility, satisfaction, and quality of life (QoL) among prosthesis users with dysvascular/diabetic amputation at both acute and long-term phases of prosthetic rehabilitation.</p><p><strong>Methods: </strong>This is a multisite, cross-sectional outcomes analysis. A total of 341 individuals met the inclusion/exclusion criteria. Individuals were grouped into acute phases (0-3 months [n = 24], 4-6 months [n = 72]) and chronic phases (24-36 months [n = 91], 37-48 months [n = 53], 49-60 months [n = 47], and 60-84 months [n = 54]) after amputation. Mobility was measured with the Prosthetic Limb Users Survey of Mobility (PLUS-M), whereas QoL and satisfaction (Sat) were reported using 10-point scales adapted from the Prosthesis Evaluation Questionnaire-Well-Being (PEQ-WB). Composite PEQ-WB scores were also compared.</p><p><strong>Results: </strong>The average mobility, QoL, and Sat among prosthesis users was, respectively, 44.8 ± 10.6, 7.6 ± 2.2, and 7.6 ± 2.2. There were no observed differences in mobility (<i>F</i> _5,330 = 1.52, <i>P</i> = 0.18), QoL (<i>F</i> _5,333 = 0.78, <i>P</i> = 0.57), or PEQ-WB (<i>F</i> _5,335 = 1.618, <i>P</i> = 0.155) between any groups. For Sat, there was a group difference (<i>F</i> _5,334 = 2.44, <i>P</i> = 0.03) as individuals appear to experience an initial increase in Sat with receipt of a prosthesis (0-3 months) compared with 25 to 36 months (<i>P</i> = 0.005), 49 to 60 months (<i>P</i> = 0.008), and 61 to 84 months (<i>P</i> = 0.009).</p><p><strong>Conclusions: </strong>Those individuals with amputation secondary to dysvascular disease and diabetes who continue to participate in prosthetic rehabilitation appear to experience levels of mobility, Sat, and QoL 7 years after amputation comparable to that reported in the first 6 months postamputation. There may be a modest increase in Sat with receipt of an initial prosthesis, potentially due to an increased optimism for one's situation. Notably, the mobility levels observed in the dysvascular population through a range of long-term postamputation periods remain within a single standard deviation of the population mean for individuals with a lower-limb amputation using a prosthesis for mobility.</p>","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"33 3","pages":"161-167"},"PeriodicalIF":0.6,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/f3/jp-33-161.PMC8216599.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39111471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life Evaluation Through a Single-Item “Daily Prosthesis Usage Time” in Individuals with Lower-Limb Amputation","authors":"S. Topuz, Ö. Ülger, Y. Yakut, Gülseren Yazicioğlu","doi":"10.1097/JPO.0000000000000381","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000381","url":null,"abstract":"ABSTRACT Introduction The purpose of this study was to identify the relation of daily prosthesis usage time (DPUT) of individuals with amputation with quality of life (QoL) questionnaires. Methods The research was carried out on 125 individuals with amputation. Prosthetic-related parameters were searched, as well as demographic data. A generic (Nottingham Health Profile [NHP]) questionnaire and a questionnaire specific to individuals with amputation (Trinity Amputation and Prosthesis Experience Scales [TAPES]) QoL measurements were used. Results Ninety-one males and 28 females with a mean age of 42.4 ± 14.7 years participated in the study. The average DPUT was 11.1 ± 4.4 hrs/d. Study results showed that there was significant correlation between both of the QoL questionnaires (NHP and TAPES) and DPUT. High correlation was determined between DPUT and NHP total score and NHP-Pain, and very high correlation was found between DPUT and NHP–Physical Activity subscale. A moderate negative correlation was found between DPUT and NHP–Energy Level, NHP–Emotional Reaction, NHP–Social Isolation, and NHP–Sleep. A moderate negative correlation was found between DPUT and TAPES–Activity Restriction. A high correlation was found between DPUT and residual limb pain, prosthetic satisfaction, time interval after amputation, and number of prosthetic fittings. A moderate correlation was found between DPUT and walking aids, whereas a poor relationship was shown between phantom pain and DPUT. Conclusions This study showed that “the average DPUT” may be used in terms of short assessment of QoL of individuals with amputation. The outcomes of this study pointed out that especially prosthetic-related parameters affected the QoL in individuals with amputation. In problems resulting from routine assessment and questionnaires having so many items, a single-item question, “the average DPUT,” may be used effectively in a shorter period and is helpful for organizing a rehabilitation program. Clinical Relevance A single-item question, “The average daily prosthesis usage time (DPUT),” be used effectively in a shorter assessment of quality of life of individuals with amputation and is helpful for organizing a rehabilitation program.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"241 - 245"},"PeriodicalIF":0.6,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47608065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Year-Long Use of Ankle-Foot Orthosis–Footwear Combination with Talar Flange Modification in an Adult Poststroke","authors":"D. McGovern, S. Fatone","doi":"10.1097/JPO.0000000000000375","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000375","url":null,"abstract":"ABSTRACT Introduction There are limited examples in the literature of detailed orthotic management related to triplanar control of the ankle-foot complex. The aim of this case report was to describe year-long use of an ankle-foot orthosis–footwear combination (AFO-FC) augmented with a talar flange that aimed to stabilize the subtalar joint during gait in an individual with poststroke hemiplegia who presented with both knee hyperextension and an unstable subtalar joint. Materials and Methods A 40-year-old woman 1-year poststroke with right hemiplegia presented with right equinovarus and knee hyperextension, with complaint of pain in the ankle and knee. Her right talocrural joint measured 15° plantarflexion with clinically significant inversion instability. Results A right solid AFO-FC, designed using published algorithms, was provided. In addition, a talar flange modification was incorporated to control subtalar inversion. During year-long use of the AFO-FC, the patient was able to return to community ambulation without pain. Successful orthotic intervention required that the device met not only biomechanical goals but also broader patient goals, which changed over time. Therapy with the device was also important for successful orthotic intervention. Conclusions This case illustrates use of a talar flange in an AFO-FC to provide triplanar control of the ankle-foot complex and improve gait in a person poststroke.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"e55 - e60"},"PeriodicalIF":0.6,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41518005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Knee Orthosis to Advance Motor Control in a 3-Year-Old with Achondroplasia: A Case Report","authors":"J. Parent-Nichols, Deb Chamberlain","doi":"10.1097/JPO.0000000000000377","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000377","url":null,"abstract":"ABSTRACT Introduction Children with achondroplasia experience numerous impairments in body structure and function, including hypotonicity, weakness, joint laxity/hypermobility, skeletal malalignment, and delays in gross motor development. Atypical patterns of movement are often used to compensate for short limbs, weakness, laxity at the joints, and bony malalignment. As a result of these atypical patterns, pain and self-restricted movement frequently begin at a young age. Surgical interventions are the general recommendation to address progressive deformity and resultant pain. Lower-limb bracing to address alignment and motor control in children with other diagnoses that include hypotonia has had positive results, including improved alignment and gross motor skills, but has not been explored in children with achondroplasia. Materials and Methods A 3-year-old child with achondroplasia participated in an intervention using a neoprene knee orthosis with hyperextension resistance at the knee combined with a play-based, proprioceptive-intensive home exercise program. We hypothesized that the knee orthosis would increase proprioceptive input, improve alignment, and have a positive effect on gross motor skill acquisition and refinement. Early training may also have a positive impact on potential future pain and disability. Results Improvements in alignment and motor control were seen in this child after 12 weeks of this intervention but were not initially sustained. After an additional 6 weeks of intervention, significant progress was demonstrated in lower-limb alignment and motor control, as evidenced by independent use of proper movement patterns. Delay in gross motor skill was reduced from 27% to 22%. Discussion Motor skills training in proper alignment with aid of neoprene knee orthosis resulted in positive gains for a 3-year old with achondroplasia. Conclusion This intervention may be helpful for other children with achondroplasia who experience hypotonia, malalignment, and atypical movement patterns. Sufficient amounts of practice and intensity are recommended for permanent motor learning to occur.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"e61 - e68"},"PeriodicalIF":0.6,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41509977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Level of Pediatric Amputation on Selection of Prosthetic Component Options","authors":"A. Nemade, F. Miller, M. Thacker, Geovanny Oleas-Santillán, K. Rogers","doi":"10.1097/JPO.0000000000000374","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000374","url":null,"abstract":"ABSTRACT Introduction Amputation is one of the oldest surgeries known to the human race. The principles of amputation in children are different than in adults. Common indications for amputation include congenital, traumatic, infection, malignancy, vascular, and other pathology. Improper prosthetic fitting or inability to use the most modern available prosthesis can lead to dissatisfaction and compromised high-level function. The aim of this study was to assess residual limbs for compatibility to fit the most modern prosthetic components. Methods This study is a retrospective review of medical records of patients who underwent amputation between the pelvis and midfoot before 18 years of age. Age, sex, etiology, and level of amputation were recorded. A senior certified prosthetist graded the limbs based on limitations the residual limb imposed on options for the highest functioning modern prosthetic components. Results Sixty-one patients were identified (35 male, 26 female) with a mean age at assessment of 17.35 years (range, 1.86–35.35 years). Congenital causes and tumors were the most common etiology. Amputations around the ankle were most common (25), followed by transtibial (20). There were 59% grade 1 limbs with no restrictions to component options, 28% grade 2 with moderate restrictions, and 13% grade 3 or severely limited component options due to the residual limb. Most grade 1 residual limbs were transtibial or proximal. Amputations distal to transtibial were of all grades. Conclusions The choices for optimal high-level prosthetic components are much less limited for transtibial amputation than more distal amputations leading to potentially less high-level prosthetic function. Managing the residual limb length and prosthetic fitting ability is an important element in pediatric amputations if the goal is to fit mature young adults with the highest functioning level prosthetic components.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"10 - 13"},"PeriodicalIF":0.6,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42273050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of 3D Printing Technology for Cervical Thoracic Lumbosacral Orthosis Fabrication","authors":"Miranda L Yelvington, Gregory Armstrong, Ellen Mallard, Ankita Shukla, Eric Braden","doi":"10.1097/JPO.0000000000000379","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000379","url":null,"abstract":"ABSTRACT Introduction This case report describes orthotic design using computed tomography and three-dimensional printing technology combined with traditional orthotic modalities in a newborn patient with chondrodysplasia punctata and cervical spinal stenosis. At day 5 of life, the infant was referred for fitting with a prefabricated cervical collar. Because of the infant's unique stature and small size, traditional prefabricated devices could not be used. The spinal instability and critical nature of the infant prevented traditional methods of orthosis fabrication. A multidisciplinary team used imaging, 3D printing technology, and traditional orthosis fabrication methods to construct a cervical thoracic lumbosacral orthosis (CTLSO). Materials and Methods Using computed tomography scans, data-segmenting software, and a 3D printer, a life-sized model of the patient's upper body was constructed. Traditional plaster molding and high-temperature orthoplastic techniques were used to fabricate a custom cervical thoracic lumbosacral orthosis for spinal stabilization, necessary for safe patient transport and handling. Results The custom orthosis demonstrated proper fit and stability, as evidenced by postfitting scans. With orthosis in place, needed care could be provided to the patient more safely and efficiently. In addition, the infant could be held by the caregivers, increasing parental/infant bonding. Conclusions Technological advances, including the ability to use computer tomography scans in combination with three-dimensional printers, can be a safe and effective option in situations of difficult orthosis fabrication for medically fragile patients.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"e50 - e54"},"PeriodicalIF":0.6,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43561281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Prosthetists' Perspectives on Adjustable-Volume Lower-Limb Prosthetic Sockets","authors":"Emily A. Barr, Kelsey Ebbs, J. Wensman, A. Gutierrez, N. Rosenblatt, D. Gates","doi":"10.1097/JPO.0000000000000376","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000376","url":null,"abstract":"ABSTRACT Introduction Adjustable-volume prosthetic sockets have been available for many years to address residual limb volume changes, although little research has been conducted regarding their efficacy. As such, prosthetists are guided by patient preference, personal experience, and professional perception. The purpose of this study was to explore clinician perceptions and experiences fitting adjustable-volume prosthetic sockets. Materials and Methods An anonymous online survey was distributed to certified prosthetists. The survey contained questions about prosthetists' demographics, whether they had previously fit an adjustable-volume prosthetic socket, whether these fittings were successful, and what challenges they experienced. Those who had not previously fit adjustable sockets were asked what barriers had prevented them from doing so. Results A total of 221 certified prosthetists completed the survey. Of the 195 eligible respondents, 82% had experience in fitting adjustable prosthetic sockets. The most commonly fit socket styles were the RevoFit (n = 123), Socket-less (n = 67), and Infinite (n = 66) sockets. Prosthetists had varied success with the different socket styles, with the RevoFit being the most successful, and the Infinite and Socket-less sockets the least successful. Respondents most frequently noted increased bulk (93% of respondents; n = 181), complicated fabrication (72%; n = 141), and poor cosmesis (65%; n = 127) as challenges faced when fitting adjustable-volume sockets. Some respondents felt these sockets were a useful clinical tool; however, common themes regarding clinical perception of adjustable sockets included issues with cost/reimbursement and appropriateness for only a subset of the population of individuals with amputation only. Other respondents felt that adjustable sockets were either not adequate for clinical use or required improvements before their use would be beneficial. Conclusions There is no majority opinion regarding the benefits and challenges of adjustable sockets among prosthetists. In general, prosthetists feel that adjustable sockets can be used as one of the various tools to accommodate complicated lower-limb fittings. Additional work is needed to provide clinicians with a best practice guideline for providing adjustability within lower-limb sockets. Clinical Relevance The study showed that prosthetists feel that adjustable sockets can be one of the tools used for complicated lower-limb fittings. Additional work is needed to develop a best practice guideline for providing adjustability in lower-limb sockets.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"34 1","pages":"233 - 240"},"PeriodicalIF":0.6,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49035876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}