Methods to assess lower limb prosthetic adaptation: a systematic review.

Area of Science:

• Rehabilitation Engineering
• Prosthetics and Orthotics
• Biomechanics

Background:

• Lower limb amputation leads to significant physical, psychological, and functional impairments.
• High prosthetic rejection rates persist despite available objective assessment methods.
• Current prosthetic fitting relies heavily on prosthetist expertise rather than quantitative data.

Purpose of the Study:

• To review common methods for evaluating prosthetic fitting in lower limb amputees.
• To identify tools, procedures, and tests used for residual limb and outcome characterization.
• To highlight combinations of methods for indirect prosthetic fitting evaluation.

Main Methods:

• Systematic literature search of multiple databases (2011-2023).
• Selection by four reviewers using the Rayyan tool for relevance to prosthetic fitting.
• Predominant assessment methods identified: mobility, gait, physical variables, and stability.

Main Results:

• Mobility evaluation is the primary predictor of prosthetic fitting success in clinical settings.
• Functional tests and self-report questionnaires are widely used due to accessibility.
• Laboratory-based methods for specific variable measurement are often inaccessible in clinics.

Conclusions:

• Mobility assessment is the most critical factor for successful prosthetic fitting in clinical practice.
• Future research should focus on translating advanced, lab-based measurement techniques into clinical environments.
• Bridging the gap between research and clinical practice is essential for improving prosthetic outcomes.