Effects of the unity vacuum suspension system on transtibial gait for simulated non-level surfaces

Thibault, Gabrielle; Gholizadeh, Hossein; Sinitski, Emily H.; Baddour, Natalie; Lemaire, Edward D.

doi:10.1371/journal.pone.0199181

Cited by 7 publications

(8 citation statements)

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“…Whether vacuum in VASS sockets was active or inactive was shown to have a small but significant effect on a few gait parameters. 63 In particular, gait was affected when the vacuum pumps were off for an extended period of time possibly due to increased residual limb volume fluctuation and poor socket fit. 63 While much has been learned about vacuum over the last two decades, future studies are needed to systematically evaluate and compare different vacuum systems, to study use of vacuum over longer periods of time, to explore the effect of vacuum during different activity levels and functional tasks, and to explore the effect of vacuum in patients with varying characteristics, such as residual limb geometry and tissue type.…”

Section: Vacuum Level In Vacuum Assisted Suction Suspensionmentioning

confidence: 99%

Lower limb prosthetic interfaces

Safari

2020

Prosthetics &Amp; Orthotics International

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The human–prosthesis interface is one of the most complicated challenges facing the field of prosthetics, despite substantive investments in research and development by researchers and clinicians around the world. The journal of the International Society for Prosthetics and Orthotics, Prosthetics and Orthotics International, has contributed substantively to the growing body of knowledge on this topic. In celebrating the 50th anniversary of the International Society for Prosthetics and Orthotics, this narrative review aims to explore how human–prosthesis interfaces have changed over the last five decades; how research has contributed to an understanding of interface mechanics; how clinical practice has been informed as a result; and what might be potential future directions. Studies reporting on comparison, design, manufacturing and evaluation of lower limb prosthetic sockets, and osseointegration were considered. This review demonstrates that, over the last 50 years, clinical research has improved our understanding of socket designs and their effects; however, high-quality research is still needed. In particular, there have been advances in the development of volume and thermal control mechanisms with a few designs having the potential for clinical application. Similarly, advances in sensing technology, soft tissue quantification techniques, computing technology, and additive manufacturing are moving towards enabling automated, data-driven manufacturing of sockets. In people who are unable to use a prosthetic socket, osseointegration provides a functional solution not available 50 years ago. Furthermore, osseointegration has the potential to facilitate neuromuscular integration. Despite these advances, further improvement in mechanical features of implants, and infection control and prevention are needed.

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Section: Vacuum Level In Vacuum Assisted Suction Suspensionmentioning

confidence: 99%

Lower limb prosthetic interfaces

Safari

2020

Prosthetics &Amp; Orthotics International

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“…This methodology has been described in detail in our previous publications. [13][14][15] The average self-selected walking speed for the control group was slightly higher (mean: 1.29 (SD: 0.06) m/s). Each walking trial was 340 m that included: level walking; down slope (7° decline); up slope (7° incline); right and left slopes (5° slope); medial-lateral translations (platform oscillates in the medial-lateral direction); hilly (platform oscillates in the sagittal plane); and rocky conditions.…”

Section: Data Collectionmentioning

confidence: 99%

“…In our previous research, we assessed the effect of Össur's Unity Figure 1 elevated vacuum suspension system (https://assets.ossur.com/library/33281/Unity) on gait parameters while the vacuum was active or inactive. [13][14][15] We found significant differences between vacuum conditions for some gait parameters, but differences were small and may not be clinically relevant. However, step length symmetry between intact and prosthetic limbs improved with active elevated vacuum.…”

Section: Introductionmentioning

confidence: 99%

Effects of Unity Prosthetic Elevated Vacuum Suspension System on Minimum Swing Toe Clearance

Gholizadeh

Lemaire

Nantel

2021

Can. Prosthet. Orthot. J.

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BACKGROUND: The risk of tripping in people with amputation is greater than that of able-bodied individuals due to reduced toe clearance during the swing phase. Appropriate prosthetic suspension may increase toe clearance by providing more secured attachment between the residual limb and prosthetic socket. Research is lacking on the Unity suspension system's effect on swing toe clearance. METHODS: Twelve people with transtibial amputation were fitted with the Unity suspension system. After one month accommodation period, the person walked with active (ON) or inactive vacuum (OFF) in a CAREN-Extended virtual reality system, across multiple simulated real-world scenarios. Prosthetics minimum swing toe clearance, and kinematic data, while the vacuum was ON or OFF, were compared with the intact side and a group of 12 able-bodied individuals. RESULTS: Minimum swing toe clearance (MSTC) and knee flexion angle were larger on the prosthetic side (active and inactive vacuum) compared to both the intact side and the control group. However, hip flexion angle on the prosthetic side was approximately 17% smaller than the control group. Unlike the control group, MSTC with active and inactive vacuum suspension was not significantly different between level walking and other walking conditions. Finally, among all walking conditions, the lowest swing toe clearance for both control and the amputee groups was recorded when the limb was at the top of a side-slope. CONCLUSION: An effective suspension system could improve toe clearance; however, significant differences were not found between active and inactive vacuum conditions. The likelihood of inappropriate foot contact on side-slope ground might be greater than other walking conditions for both able-bodied and amputee groups, possibly leading to stumbling or falling. Layman's Abstract Walking over non-level surfaces are more challenging than level walking, especially for people with below the knee amputation. Moreover, due to reduced toe clearance during the gait, people with amputation have higher risk of tripping and falling than able-bodied individuals. The purpose of this study was to evaluate the effects of a prosthetic suspension system, a critical component that connects the residual limb to the prosthesis, on toe clearance during gait across multiple simulated real-world walking scenarios. Twelve people with below the knee amputation and a group of 12 able-bodied individuals participated in this study. The results of this study showed that an effective suspension system could improve toe clearance during swing phase. The likelihood of inappropriate foot contact on side-slope ground might be greater than other walking conditions for both able-bodied and amputee group, possibly leading to stumbling or falling. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36847/28624 How To Cite: Gholizadeh H, Lemaire E.D, Nantel J. Effects of unity prosthetic elevated vacuum suspension system on minimum swing toe clearance. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.1. https://doi.org/10.33137/cpoj.v5i1.36847 Corresponding Author: Julie Nantel, PhD School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada, K1N 6N5E-Mail: jnantel@uottawa.caORCID ID: https://orcid.org/0000-0001-7253-9222

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“…Suspension systems are chosen based on patient needs, preferences, and condition of the residual limb. Advanced prosthetic suspension has been reported to exhibit such effects as improved gait performance and balance, 4,6,8,13 increased comfort and quality of life, 4,5,12,14 improved circulation, better management of limb volume fluctuation and edema, 3,14 improved wound healing, protection against skin damage, and reduced interface pressures and skin problems. [14][15][16] Although various adverse and positive effects have been reported for suspension systems, 7,11,[16][17][18] we think that it is necessary to examine the effects of PSS and VASS as they are the most preferred suspension systems by persons with transtibial amputation.…”

mentioning

confidence: 99%

“…A good prosthetic fit allows forces to be effectively dispersed between the residual limb and socket and increases comfort level by reducing peak compression and shear forces acting on the residual limb 3 . Previous studies have investigated the effects of different suspension systems available for individuals with transtibial amputation 4–11 …”

mentioning

confidence: 99%

A Comparison of the Effects of Pin and Vacuum-Assisted Suspension Systems in Individuals With Transtibial Amputation

Duygu¹,

Anaforoğlu²,

Erbahçeci³

2022

J Prosthet Orthot

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IntroductionSuspension systems are essential components for a lower-limb prosthesis, as they provide sufficient prosthetic fit. Although various adverse and positive effects have been reported for suspension systems, it is important to determine the effects on the prosthesis users in detail.ObjectiveThe aim of this study was to compare the pin suspension system (PSS) with the vacuum-assisted suspension system (VASS) in terms of parameters including walking capacity, functional mobility, weight bearing on the operated side, prosthesis satisfaction, and body image perception.Study DesignThis is an original research report.MethodsNine individuals with transtibial amputation were evaluated. Both suspension systems were applied consecutively. Initially, participants used the PSS for 3 months after fabrication and adjustment of the prosthesis and a prosthetic training period. They then used the VASS for 3 months after a similar training period. After both prosthetic systems had been adjusted, L.A.S.A.R. Posture was used to determine weight bearing on the prosthetic side. The 6-minute walk test was applied for walking capacity, the timed up-and-go test was used to determine functional mobility, the Prosthetic Satisfaction Index was used for prosthetic satisfaction, and the Amputee Body Image Scale was used for body image perception.ResultsSignificant differences were observed between PSS and VASS in terms of prosthetic side weight-bearing ratios, walking capacity, functional mobility, and prosthetic satisfaction (P < 0.05), all in favor of VASS. No significant difference was determined in terms of body image scores (P > 0.05).ConclusionIn terms of function and prosthetic satisfaction in individuals with transtibial amputation, VASS was determined to be superior. The available evidence suggests that if there is no contraindication for the use of VASS, it may contribute to the individual with amputation functionally and increase the satisfaction with the prosthesis.Clinical RelevanceVacuum systems can make a positive contribution to reaching the goals for prosthesis users who are targeted to have high physical activity levels. This positive contribution includes increased weight transfer to the prosthetic side, an increase in mobility determinants, and increased prosthesis satisfaction, which has many dimensions.

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Effects of the unity vacuum suspension system on transtibial gait for simulated non-level surfaces

Cited by 7 publications

References 20 publications

Lower limb prosthetic interfaces

Lower limb prosthetic interfaces

Effects of Unity Prosthetic Elevated Vacuum Suspension System on Minimum Swing Toe Clearance

A Comparison of the Effects of Pin and Vacuum-Assisted Suspension Systems in Individuals With Transtibial Amputation

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