Gait, cost and time implications for changing from PTB to ICEX sockets

Area of Science:

• Prosthetics and Orthotics
• Biomechanics
• Rehabilitation Engineering

Background:

• The ICEX system offers direct stump-to-socket manufacturing for potentially improved comfort and fit.
• Traditional patellar tendon bearing (PTB) sockets are widely used for trans-tibial amputees.
• Comparative studies are needed to evaluate novel prosthetic socket technologies.

Purpose of the Study:

• To compare gait performance between ICEX and PTB sockets in trans-tibial amputees.
• To assess differences in production/fitting times and financial implications.
• To evaluate amputees' subjective comfort with the ICEX system.

Main Methods:

• A randomized controlled trial involving 21 trans-tibial amputees comparing ICEX and PTB sockets.
• Gait analysis using force plates to measure kinetic data.
• Subjective comfort assessment via the Socket Comfort Score and adjustment visit frequency.

Main Results:

• No significant differences were observed in measured gait parameters between the ICEX and PTB groups.
• ICEX sockets were quicker to manufacture, but incurred significantly higher overall production costs.
• Amputees reported only minor comfort preferences for ICEX, with no significant difference in adjustment frequency.

Conclusions:

• The ICEX system does not offer significant advantages in gait performance or socket comfort for trans-tibial amputees compared to PTB sockets.
• The considerably higher cost of ICEX, without demonstrated benefits, precludes its recommendation for routine use.
• Further research may explore specific patient subgroups who could benefit from ICEX technology.