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Title: Trans-tibial prosthetic system design and benefits for the amputee, service providers and society : an evidence based clinical study
Author: Dumbleton, Tim
ISNI:       0000 0001 3434 4539
Awarding Body: University of Strathclyde
Current Institution: University of Strathclyde
Date of Award: 2007
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Two trans-tibial socket concepts are in regular use in prosthetic clinics. These may be categorised as the "hands-on" (hand casting) concept and "hands-off' (pressure casting) concept which, in addition to the distinctive casting methods, require different liner materials and components to create the desired loading distribution. Amputees have stated that quality of fit of the prosthetic socket is of highest importance, but, although pressure distribution has long been regarded as important, there is no general consensus regarding socket fit criteria. Furthermore, the casting process is carried out with the limb stationary. During walking the pressure distribution will change constantly throughout the gait cycle. The quality of fit of the prosthesis remains very subjective with little quantitative information regarding the pressure distribution within the socket. The aim of this study was to investigate and to compare the dynamic interface pressure distribution of the two socket concepts for a trans-tibial amputee population. In addition, the impact of the two socket concepts on their daily living activities was assessed. The objective was to relate measured pressure distribution to activity level and patient acceptance and thus increase understanding of what constitutes a good socket fit. The dynamic interface pressure distribution inside the socket of 48 patient's own prosthesis was recorded, using a validated pressure measurement system. The dynamic pressures recorded between the residual limb and the prosthetic socket showed similar distributions between the different casting concepts, although overall the hands-off sockets showed higher pressures than the hands-on group. The results from the questionnaire indicated that the quality of fit of the prosthetic socket had a strong correlation with user satisfaction. Results of this study have shown that the impacts of the two distinct prosthetic socket concepts have on the life of the amputee are very similar. Most of the participants used their prosthetic device regularly, and responded in similar ways regardless of the type of socket worn.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral