Jessica Kenia, MS
Program Manager
University of Pennsylvania
Philadelphia, New Jersey, United States
Jim Marschalek, MS
VP Engineering
Advanced Design Concepts
Pewaukee, Wisconsin, United States
Frances S. Shofer, PhD
Adjunct Professor of Emergency Medicine
Department of Emergency Medicine, University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania, United States
Timothy R. Dillingham, MD, MS
Professor and Chair
Department of Physical Medicine and Rehabilitation, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania, United States
Adjustable prostheses have gained significant attention recently due to their capability to adapt to volume changes frequently experienced by persons with limb loss. A prosthesis with adjustable features was initially developed and has undergone multiple design improvements in response to wearer feedback. This research aims to assess the latest iteration of this prosthesis, focusing on its comfort, user satisfaction, and overall functionality in a group of individuals with limb loss.
Design:
This is a prospective trial where participants with transtibial limb loss were fit in one session with an adjustable transtibial prosthesis and instructed to wear it for a two-week trial period. Participants completed a Prosthetic Evaluation Questionnaire (PEQ) based survey on their conventional prosthesis at the initial visit and on the adjustable prosthesis at follow up. The survey included 12 questions on comfort, stability, and utility using a 5-point scale (1=poor to 5=excellent) for each (60 points total). Falls, skin abrasions, or device mechanical failures were recorded. Paired t-tests were used to assess differences in PEQ scores between the conventional and immediate fit device.
Results: Seven subjects (5 men, 2 women) completed the trial (average age 57.9 ± 14.0 years). PEQ scores for the adjustable devices versus the subjects’ conventional prostheses were higher (51.3 vs 42.1, p=.15). Additionally, for all 12 questions, the adjustable prosthesis was rated the same or better than the person’s conventional prosthesis (mean difference range: 0.43-1.43). Standing stability achieved statistical significance and the adjustable prosthesis was better (mean difference=.86, p=.045).
Conclusions:
In this feasibility trial, the adjustable transtibial prosthetic system was as good or better than conventionally made prostheses. This suggests that the adjustable prosthesis is a feasible option for persons with limb loss who want an adjustable socket for comfort and improved function.
