title: Perception of socket alignment perturbations in amputees with transtibial prostheses.
abstract: A person with amputation's subjective perception is the only tool available to describe fit and comfort to a prosthetist. However, few studies have investigated the effect of alignment on this perception. The aim of this article is to determine whether people with amputation could perceive the alignment perturbations of their prostheses and effectively communicate them. A randomized controlled perturbation of angular (3 and 6 degrees) and translational (5 and 10 mm) alignments in the sagittal (flexion, extension, and anterior and posterior translations) and coronal (abduction, adduction, and medial and lateral translations) planes were induced from an aligned condition in 11 subjects with transtibial prostheses. The perception was evaluated when standing (static) and immediately after walking (dynamic) using software that used a visual analog scale under each alignment condition. In the coronal plane, Friedman test demonstrated general statistical differences in static (p < 0.001) and dynamic (p < 0.001) measures of perceptions with angular perturbations. In the sagittal plane, it also demonstrated general statistical differences in late-stance dynamic measures of perceptions (p < 0.001) with angular perturbations, as well as in early-stance dynamic measures of perceptions (p < 0.05) with translational perturbations. Fisher exact test suggested that people with amputation's perceptions were good indicators for coronal angle malalignments but less reliable when defining other alignment conditions.
authors.affiliation: Orthocare Innovations, 6405 218th St SW, Suite 301, Mountlake Terrace, WA 98043, USA. dboone@orthocareinnovations.com
authors.forename: David A
authors.initials: DA
authors.lastname: Boone
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Teri G
authors.initials: TG
authors.lastname: Chou
authors.forename: Adam K
authors.initials: AK
authors.lastname: Arabian
authors.forename: Kim L
authors.initials: KL
authors.lastname: Coleman
authors.forename: Michael S
authors.initials: MS
authors.lastname: Orendurff
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation*; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D003142:Communication; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010465:Perception; D017755:Prosthesis Fitting; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013977:Tibia; D016138:Walking / Q000502:physiology