Elastomeric liners for people with transtibial amputation: Survey of prosthetists' clinical practices

A diverse range of elastomeric liner products are available to people with transtibial amputation. However, little information is available about how prosthetists select the product best suited to each patient.

To determine how prosthetists obtain information about liners, which features are most relevant to the selection process, and which products are used most for patients with transtibial amputation.

Cross-sectional survey.

A custom online survey was developed to solicit information about prosthetists' liner selection practices. Prosthetists with experience managing transtibial patients were recruited via advertisements posted in magazines, at conferences, and on a listserv. Responses were analyzed to characterize prosthetists' liner selection practices.

Data from 106 experienced prosthetists (mean age: 44.4 years, mean experience: 15.7 years) were included. Most prosthetists (94%) obtained liner information from manufacturer representatives, websites, or literature. On average, respondents factored nine different liner characteristics into their selection processes. Prosthetists reported experience with 16 unique liner products with their transtibial patients, but routinely used fewer than 3.

Although many different prosthetic liners are available, prosthetists regularly use only a few select liner products. Tools or strategies to objectively compare prosthetic liners across manufacturers are likely needed to facilitate more diverse prescription practices. Clinical relevance Knowledge of prosthetists' prosthetic liner selection practices may guide development of evidence-based resources or tools to facilitate matching patients with appropriate liners. Results of this study may also inform researchers and manufacturers about desirable liner characteristics and direct development of novel liner products to address prosthetists' clinical needs.