Perception of socket alignment perturbations in amputees with transtibial prostheses

Area of Science:

• Prosthetics and Orthotics
• Biomechanical Engineering
• Human Factors Engineering

Background:

• Subjective perception is crucial for prosthetic fit and comfort.
• Limited research exists on how prosthesis alignment affects patient perception.
• Effective communication of alignment issues is vital for optimal prosthetic use.

Purpose of the Study:

• To investigate if individuals with amputation can detect and communicate prosthesis alignment perturbations.
• To assess the reliability of subjective perception in identifying specific alignment deviations.

Main Methods:

• 11 subjects with transtibial prostheses underwent randomized angular and translational alignment changes in sagittal and coronal planes.
• Perception was assessed in static standing and dynamic walking using a visual analog scale.
• Statistical analysis (Friedman, Fisher exact tests) evaluated perception differences and reliability.

Main Results:

• Significant differences in perception were found for angular perturbations in the coronal plane (static and dynamic).
• Angular perturbations in the sagittal plane (late stance) and translational perturbations (early stance) also showed significant perceptual differences.
• Subjective perceptions were reliable indicators for coronal angular malalignments but less so for other alignment types.

Conclusions:

• Individuals with amputation can perceive certain prosthesis alignment changes, especially angular deviations in the coronal plane.
• Reliance on subjective perception alone may be insufficient for diagnosing all types of prosthesis malalignments.
• Further research is needed to enhance objective measures for prosthetic alignment assessment.