A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature

Tafti, Nahid; Hemmati, Fatemeh; Safari, Reza; Karimi, Mohammad Taghi; Farmani, Farzad; Khalaf, Ali Qusay; Mardani, Mohammad Ali

doi:10.1177/0954411918789450

Cited by 6 publications

(6 citation statements)

References 42 publications

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“…In the prosthetics field, questionnaires have also been used to assess prostheses, mobility outcomes, and quality of life, but none have been designed specifically for assessing the quality of prosthetic alignment. Therefore, various research studies have tried to find more quantitative techniques 11 and optimization criteria for prosthetic alignment 12 that can assist and guide the prosthetist to obtaining an acceptable prosthetic alignment because it facilitates stable ambulation, enhance comfort, produce aesthetic gait appearance, and lower the energy cost of walking. 13 Despite advances in prosthetic technology, amputees, prosthetists, researchers, and manufacturers have insisted that the quality of prosthetic alignment requires improvements in which alignment needs improved tools for prosthetists, improved communication between amputees and prosthetists, as well as knowledge of alignment-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…16 There are a few systematic reviews that have developed approaches to evaluate existing measurement parameters, or variables used to assess clinically acceptable alignment, which is primarily focused on studies that examine the effect of changes in TT prosthetic alignment on the total body, gait symmetry, electromyography and oxygen consumption, TT socket pressure changes, spatiotemporal, kinematic, as well as kinetic gait parameters. [11][12][13]17,18 In this systematic review, as the primary research question, the current literature on TT prosthetic alignment will be examined to scope the qualitative and quantitative methods that were intended to assist prosthetists in achieving an acceptable TT prosthetic alignment. This study is also aimed to shed the light on the reported TT prosthetic alignment instruments/devices and their clinical feasibility.…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of methods used to assist transtibial prosthetic alignment decision-making

Malaheem,

Abd Razak,

Abu Osman

2023

Prosthetics &Amp; Orthotics International

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Prosthetic alignment is a highly subjective process that is still based on clinical judgments. Thus, researchers have aimed their effort to quantify prosthetic alignment by providing an objective method that can assist and guide prosthetists in achieving transtibial (TT) prosthetic alignment. This systematic review aimed to examine the current literature on TT prosthetic alignment to scope the qualitative and quantitative methods designed to guide prosthetists throughout the TT prosthetic alignment process as well as evaluate the reported instruments and devices that are used to align TT prostheses and their clinical feasibility. A literature search, completed in June 2022, was performed using the following databases: Web of Science (Clarivate), SCOPUS (Elsevier), and Pub Med (Medline) with searching terms focusing on TT, prosthesis, prosthetist, prosthetic alignment, and questionnaires, resulting in 2790 studies being screened. Twenty-four studies have used quantitative methodologies, where sensor technologies were found to be the most frequently proposed technology combined with gait analysis tools and/or subjective assessments. A qualitative method that assists prosthetists throughout the alignment process was not found. In this systematic review, we presented diverse methods for guiding and assisting clinical decision-making regarding TT prosthetic alignment. However, most of these methods considered varied parameters, and there is a need for elaboration toward standardized methods, which would improve the prosthetic alignment clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A systematic review of methods used to assist transtibial prosthetic alignment decision-making

Malaheem,

Abd Razak,

Abu Osman

2023

Prosthetics &Amp; Orthotics International

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“…6 In the clinic, it is usually based on gait observations of professionals (prosthetists, physicians, and physical therapists) and the experiences of the patient. [7][8][9] The goal is to create a comfortable, natural gait pattern, with the least possible asymmetry and compensation in the contralateral leg and core. 9 The prosthetic alignment, especially the "fine-tuning" of the prosthesis based on the patient's needs, is an ongoing process during subacute rehabilitation because the stump often undergoes several changes during this period and the patient develops a better understanding of adequate alignment.…”

Section: Introductionmentioning

confidence: 99%

The effects of small variations in shoe heel height on gait in people with a transtibial amputation

Oorschot

Hofstad

Slagman

et al. 2022

Prosthetics &Amp; Orthotics International

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Background:Shoe heel height is considered to influence prosthetic alignment, walking comfort, and gait symmetry in people with a transtibial amputation (TTA). However, research on the effect of heel height is scarce, and no evidence is available on the effects of variations smaller than 20 mm. These small heel height variations between store-bought shoes are often overlooked by people with an amputation and may cause secondary musculoskeletal problems in the long term.Objective:To examine the effects of small increases in heel height on gait symmetry in people with a TTA and healthy individuals.Study design:Experimental repeated measures study.Methods:Fourteen participants with a TTA and 15 healthy controls were included. Pressure data, spatiotemporal data, and experienced walking comfort were measured during walking with four heel height conditions: original height and increased heights of 3, 5, and 8 mm. Symmetry in center of pressure velocity (VCOP), gait parameters, and experienced walking comfort were compared between the heel heights and between healthy controls and prosthetic walkers.Results:Increased heel height resulted in a significant decrease in VCOP symmetry (P = 0.001) and experienced walking comfort (P < 0.001). The VCOP trajectory of the prosthetic leg mainly differed within the first 14.5% of the stance phase. Healthy individuals showed better VCOP symmetry in all conditions (P < 0.001).Conclusions:Healthcare professionals should advice their clients to be alert of small heel height differences between store-bought shoes, especially those larger than 5 mm. A prosthetic alignment adjustment should be considered when purchasing new shoes.

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“…4 Comfort and function of the prosthesis critically depend on the socket alignment and fit. 4–6…”

Section: Introductionmentioning

confidence: 99%

Multi-scale semi-analytical model for fatigue life prediction of trans-tibial prosthetic sockets

Mankai

Smida

Chafra

et al. 2021

Proc Inst Mech Eng H

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The trans-tibial socket is an essential component of the prosthesis that connects it to the residual limb. Socket misalignments and permanent deformations reduce the comfort of the amputee. In order to forestall such issues, sufficient information about the socket lifespan needs to be acquired, which is fairly difficult given the lack of calculation methods that estimate the fatigue life in the literature. In this paper a semi-analytical model is proposed based on experimental results. It highlights the effects of the amputee average daily walking time on the socket fatigue life. A proportionality relationship is demonstrated linking the Burgers model parameters at the structural scale to those at the macroscopic scale. Hence, it becomes possible to evaluate the permanent deformation that induces a misalignment in the socket. These results are useful for the designers to predict the fatigue life of the socket, and also for clinicians to monitor the mechanical degradation of the trans-tibial socket and schedule maintenance or replacement.

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A systematic review of variables used to assess clinically acceptable alignment of unilateral transtibial amputees in the literature

Cited by 6 publications

References 42 publications

A systematic review of methods used to assist transtibial prosthetic alignment decision-making

A systematic review of methods used to assist transtibial prosthetic alignment decision-making

The effects of small variations in shoe heel height on gait in people with a transtibial amputation

Multi-scale semi-analytical model for fatigue life prediction of trans-tibial prosthetic sockets

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