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Soft Dynamic Fluidic Cushion for Pressure Sore Management in Transtibial Prosthetics: A Proof-of-Concept Study
IEEE Transactions on Bio-Medical Engineering
|August 19, 2025
Summary
A novel dynamic fluidic cushion reduces high pressure on the fibular head during gait, preventing skin breakdown in prosthetic users. This low-profile device offers targeted unloading, improving prosthetic socket fit and comfort.
Area of Science:
- Biomedical Engineering
- Prosthetics and Orthotics
- Materials Science
Background:
- Prosthetic socket use can lead to skin breakdown at bony prominences due to sustained pressure and shear forces during gait.
- Volume fluctuations in residual limbs exacerbate pressure points, particularly at the fibular head, increasing the risk of tissue damage.
- Current prosthetic fitting methods may not adequately address dynamic pressure changes throughout the gait cycle.
Purpose of the Study:
- To develop and evaluate a low-profile, dynamic fluidic cushion for targeted pressure relief at the fibular head during gait.
- To investigate the cushion's ability to mitigate peak contact pressures and shear stresses in prosthetic socket wearers.
- To assess the cushion's response time and effectiveness in unloading sensitive bony areas.
Main Methods:
- A proof-of-concept study utilized a low-profile (<0.5 mm thick) dynamic fluidic cushion.
- Benchtop testing was performed using a residual limb model to simulate gait conditions.
- The cushion's ability to dynamically provide localized socket fit and pressure redistribution was evaluated.
Main Results:
- The dynamic cushion effectively unloaded high pressures at the fibular head during the stance phase for body weights up to 80 kg.
- Peak contact pressure at the fibular head was reduced by up to 94% (from 98 kPa to 6 kPa).
- The cushion demonstrated a response time of 250 milliseconds, enabling it to activate during stance and deactivate during swing.
Conclusions:
- The dynamic fluidic cushion shows significant potential for preventing skin damage at pressure-sensitive areas during gait.
- This technology can offer localized unloading, benefiting individuals with complex limb geometries and challenging prosthetic fits.
- A complementary method using elastomer sheets and a heat press may be integrated into prosthetist workflows for adjustable socket fit.
