In this study, we investigated and compared the dynamic interface pressure distribution of hands-off and handson transtibial prosthetic systems by means of pressure mapping. Of the 48 established unilateral amputees recruited, half (n = 24) had been wearing pressure-cast prostheses (IceCast Compact) and the other half (n = 24) had been wearing hand-cast sockets of the patellar tendon bearing design. We measured the dynamic pressure profile of more than 90% of the area within each prosthetic socket by means of four Tekscan F-Scan socket transducer arrays. We compared the interface pressure between socket concepts. We found that the distribution of dynamic pressure at the limb-socket interface was similar for the two intervention (socket prescription) groups. However, a significant difference was found in the magnitude of the interface pressure between the two socket concepts; the interface pressures recorded in the hands-off sockets were higher than those seen in the hands-on concept. Despite the differences in interface pressure, the level of satisfaction with the sockets was similar between subject groups. The sockets instrumented for this study had been in daily use for at least 6 months, with no residual-limb health problems.

This study compared the general activity over one week and detailed activity during a 24-hour period, of 48 established unilateral transtibial prostheses users. Activity was measured by instrumenting their prescribed prosthesis, which they have been using for a minimum of 6 month, with the ActivPAL™ activity monitor. Half (n=24) were fitted with a prostheses with total surface bearing (TSB) pressurecast sockets (Hands-off) and the other half (n=24) had been wearing prostheses with hand-cast (Hands-on) patella tendon bearing (PTB) sockets. As a prerequisite, the long-term reliability of the ActivPAL™ activity monitor was assessed and it was found to exhibit a high level of consistency between devices (Interclass Correlation Coefficient (ICC) of 0.997 over a 24-hour period). The monitors were utilized to examine the activity levels of two groups of transtibial prostheses users wearing their own prosthesis. Results indicated that both subject groups were active throughout the day, walking on average over 8,000 steps. No statistically significant difference in daily stepping activity was seen between the two groups (p=0.173). Despite differences in prosthetic socket design the daily activity profiles of both subject groups were similar.