Coronal plane socket stability during gait in persons with transfemoral amputation: Pilot study.

Area of Science:

• Prosthetics and Orthotics
• Biomechanics
• Rehabilitation Engineering

Background:

• Limited research exists on transfemoral socket design features influencing coronal plane stability, comfort, and gait.
• Understanding the interplay between socket design, tissue loading, and patient comfort is crucial for improving prosthetic use.

Purpose of the Study:

• To correlate socket comfort during gait with changes in ischial containment (IC) and tissue loading.
• To compare socket comfort under varying conditions of tissue loading and IC.

Main Methods:

• Six subjects with transfemoral amputations participated.
• Six socket conditions were tested: varying levels of IC (present or absent) and tissue compression (high, medium, low).
• Socket comfort, coronal plane hip moments, lateral trunk lean, step width, and walking speed were assessed.

Main Results:

• A strong negative relationship was found between comfort and combined changes in IC and tissue loading (rho = -0.89).
• When IC was present, tissue loading did not significantly affect socket comfort (p = 0.47).
• Without IC, high tissue loading maintained comfort, but medium (p = 0.04) and low (p = 0.02) loading significantly reduced it. Gait parameters remained unchanged across conditions.

Conclusions:

• Ischial containment is a primary factor for socket comfort in transfemoral prostheses.
• Medial tissue loading has minimal impact on comfort when IC is achieved.
• Sockets lacking IC require substantial tissue loading to achieve comparable comfort, while insufficient loading compromises it.