Systematic review of effects of current transtibial prosthetic socket designs—Part 2: Quantitative outcomes

Abstract

Abstract-This review is an attempt to untangle the complexity of transtibial prosthetic socket fit and perhaps find some indication of whether a particular prosthetic socket type might be best for a given situation. In addition, we identified knowledge gaps, thus providing direction for possible future research. We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using medical subject headings and standard key words to search for articles in relevant databases. No restrictions were made on study design and type of outcome measure used. From the obtained search results (n = 1,863), 35 articles were included. The relevant data were entered into a predefined data form that included the Downs and Black risk of bias assessment checklist. This article presents the results from the systematic review of the quantitative outcomes (n = 27 articles). Trends indicate that vacuum-assisted suction sockets improve gait symmetry, volume control, and residual limb health more than other socket designs. Hydrostatic sockets seem to create less inconsistent socket fittings, reducing a problem that greatly influences outcome measures. Knowledge gaps exist in the understanding of clinically meaningful changes in socket fit and its effect on biomechanical outcomes. Further, safe and comfortable pressure thresholds under various conditions should be determined through a systematic approach.

Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes

“…For example, footwear may substantially affect regional and overall stiffness and damping of prosthetic feet, in some instances normalizing the mechanical function across designs 35, 37, 39, 70 . Additionally, the choice of suspension system and constituent components 71 will play a role in determining the residuum-prosthesis interface properties and behavior 72, 73 , and this is especially relevant with the advent of bone-anchored prostheses (osseointegration) 74 . Therefore, a first application of the optimization process relates to evidence-based practice.…”

Voluntary Thigh Muscle Strength with Resection Stump-Dependent Blood Flow and Vasodilation in an Amputated Lower Leg with Total Surface Bearing Prosthesis during Dynamic Knee Extensor: A Case Trial

“…To overcome the disadvantages of a PTB prosthesis, a TSB prosthesis has been widely used for the stability of suspension via a silicon liner with a pin-attachment locked-adapter, which can coordinate the precise muscle force-generated as an increase in muscle strength during voluntary thigh muscle contractions. A TSB prosthesis with vacuum-assisted suction sockets may improve gait symmetry, residual limb activity [48]; therefore, we assumed that a TSB prosthesis with good fixation by a socket-silicon linear connecting thigh-stump may improve functional voluntary thigh muscle force/power during knee extension compared with a PTB prosthesis. Consequently, it was seen that proper thigh-stump muscle contraction induced LBF increases through stability with thigh stump exercise.…”

Sockets for Limb Prostheses: A Review of Existing Technologies and Open Challenges

“…Despite the recent research efforts in this field, no fully satisfactory technological solutions exist at present. A comparison between the existing sockets, analyzing their merits and drawbacks, has been made by Safari et al [6], Al-Fakin et al [7] and Chatterjee et al [8] concerning transtibial prostheses.…”