title: Pressure casting technique for transtibial prosthetic socket fit in developing countries.
abstract: This study investigated a low-cost and low-skill dependent pressure casting technique (PCAST) to fabricate and fit transtibial (TT) prosthetic sockets in a developing country. Thirteen adult volunteers (average age 47 yr) with unilateral TT amputation participated. After fitting, five participants were lost to follow-up (four rejected the prosthesis and one died). The eight remaining participants used the prosthesis for an average of 167 +/- 1 d and indicated regular use throughout this period. Success was evaluated by measures of satisfaction (Satisfaction with Prosthesis Questionnaire [SATPRO]), physical function, and gait recorded after fitting and following the usage period. SATPRO results showed high levels of satisfaction on both occasions. After the usage period, the timed up-and-go and six-minute walk performances increased by 1.7 +/- 2.0 s and 60 +/- 29 m (p = 0.001), respectively, whereas gait speed, cadence, step and stride length, support base, and percent gait cycle times remained unchanged. The results show that a TT PCAST socket (with some minor modifications) was successfully fitted to eight of the participants (success rate of 62%). It is reasonable to conclude that this technique may assist people with TT amputation in a developing country where there is a lack of trained personnel. Importantly, this technique may reduce TT prosthetic costs and increase fitting opportunity in a developing country.
authors.affiliation: Associate Professor, Department of Mechanical Engineering, University of Melbourne, Victoria, 3010, Australia. pvlee@unimelb.edu.au.
authors.forename: Peter Vee Sin
authors.initials: PV
authors.lastname: Lee
authors.forename: Noel
authors.initials: N
authors.lastname: Lythgo
authors.forename: Sheridan
authors.initials: S
authors.lastname: Laing
authors.forename: Jimmy
authors.initials: J
authors.lastname: Lavranos
authors.forename: Nguyen Hai
authors.initials: NH
authors.lastname: Thanh
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001186:Artificial Limbs / Q000191:economics*; D001696:Biomechanical Phenomena; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction; D011159:Population Surveillance; D011474:Prosthesis Design / Q000191:economics*; D017755:Prosthesis Fitting / Q000191:economics* / Q000379:methods*; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013977:Tibia / Q000601:surgery
keywords: amputee; biomechanics; gait; low-cost; patient satisfaction; pressure casting; rehabilitation; residual limb; socket; socket fit; transtibial amputation