Development and Usability of an Adjustable Prosthesis for Aquatic Therapy.

Introduction: During aquatic therapy, without a prosthesis, individuals with lower-limb difference are limited in navigating stairs or ladders, performing gait training, balance, and strengthening exercises. A noncustom prosthesis for individuals with transtibial limb difference in aquatic therapy, consisting of interchangeable sockets and pylons, does not exist. Dilatancy has not been applied within a socket to provide an accommodative shape for multiple users.

Objectives: This study explores the development and usability of an adjustable prosthesis, utilizing dilatancy, for aquatic therapy.

Study design: The design of this study is developmental.

Methods: Participants underwent an informed written consent process (IRB STU00219525). Three individuals (1 male, 55 years; and 2 female, 47 and 22 years) with unilateral transtibial amputations were recruited. A set of interchangeable adjustable sockets and pylons were developed. Utilizing dilatant properties, small particles under vacuum were assessed for their ability to provide a rigid, lightweight, and remoldable pouch within the socket. Participants trialed the prosthesis during two fittings and three aquatic therapy sessions. Upon completion, participants and treating therapists completed the System Usability Scale. Survey results were converted to a 100-point scale. Time to don the prosthesis was recorded, and socket comfort scores at the final session were averaged.

Results: The System Usability Scale indicated that the prosthesis was usable for aquatic therapy. Participant scores were 97.5, 95, and 87.5, and therapist's scores were 92.5 and 85 of a total possible 100. Average socket comfort scores were 10, 9, and 7.6/10. Times to don the prosthesis were 5:45, 5:32, and 4:10 (minutes:seconds).

Conclusions: This system functioned successfully as a noncustom prosthesis for multiple users in aquatic therapy from the participant and therapists' perspective.

Clinical relevance: The novelty of this system is utilizing a prosthesis for multiple users, improving the rehabilitation capabilities during aquatic therapy.