Editorial: Bionics limb prostheses: Advances in clinical and prosthetic care

Abstract

Importance of residuum healthThe use of a prosthesis is essential to maintain function and wellbeing of individuals suffering from limb absence (1, 2). Consequently, providers of prosthetic care recommend bespoke interventions to sustain lenient interactions between individuals' residual limb and their prosthesis (3-7). The clinical management of this interface is critical because it greatly affects the residuum health (8).Residuum health is influenced by intrinsic determinants inherent to personal demographics (e.g., gender, age, weight, and height) and surgical amputation (e.g., length of bone, muscle reassignments, muscle strength, and adipose tissue distribution) and extrinsic determinant-associated attachment (e.g., socket design and direct skeletal attachment) and prosthetic components (e.g., choice and alignment of components, control of the prosthetic joint movements, use of walking aids, and level of activity) (8). In all cases, interactions between intrinsic and extrinsic determinants are critical as residual tissues have limited physiological capacity to withstand direct loading applied by typical socket-suspended prostheses during daily activities (e.g., chafing and rubbing) (5, 9-12). In addition to general neurological residuum and phantom pain, individuals can experience a range of incapacitating neuromusculoskeletal dysfunctions compromising residuum health, such as acute and chronic skin issues, edema, neuroma, tendinitis, muscle contractures, stress fractures, osteopenia, and heterotopic bone growth, which altogether increases the risks of sound lower joints osteoarthrosis, and hyperlordosis (6,13, 14).Consequently, satisfactory residuum-prosthesis interface is difficult to achieve and sustain (15). Individuals with compromised residuum health are more at risk to experience unsuccessful prosthetic fitting arrangements (4, 16). Those with healthy residuum are more likely to maximize comfort, stability, and mobility when using a TYPE

Application of ultrasound to monitor in vivo residual bone movement within transtibial prosthetic sockets

“…Transtibial prosthetic users commonly encounter difficulties in achieving an optimal fit between their residual limb and socket, with a reported prevalence of 59% experiencing moderate to severe residual limb pain 1 , 2 . Simultaneously, prosthetists encounter difficulties in objectively evaluating the effects of their prosthetic adjustments on the loading of the residual limb 3 , 4 . Currently, prosthetic fitting relies on iterative processes, employing a trial-and-error approach to improve residual bone control.…”