title: Evaluation of an instrument-assisted dynamic prosthetic alignment technique for individuals with transtibial amputation.
abstract: BACKGROUND
  A prosthesis that is not optimally aligned can adversely influence the rehabilitation and health of the amputee. Very few studies to date evaluate the effectiveness and utility of instrument-assisted alignment techniques in clinical practice.
  
  
  OBJECTIVE
  To compare an instrument-assisted dynamic alignment technique (Compas(™)) to conventional methods.
  
  
  METHODS
  In a crossover study design, dynamic prosthetic alignments were provided to nine individuals with unilateral transtibial amputations to compare conventional and instrument-assisted alignment techniques.
  
  
  METHODS
  The instrument-assisted technique involved a commercially available force and torque sensing dynamic alignment system (Compas). Cadence, pelvic accelerations, and socket moments were assessed. A custom questionnaire was used to gather user perceptions.
  
  
  RESULTS
  No differences between alignment techniques were found in global gait measures including cadence and pelvic accelerations. No significant alignment differences were achieved by examination of angular changes between the socket and foot; however, significantly higher below-the-socket moments were found with the instrument-assisted technique. From the questionnaire, six amputees had no preference, while three preferred the conventional alignment.
  
  
  CONCLUSIONS
  The use of Compas appears to produce similar alignment results as conventional techniques, although with slightly higher moments at the socket.
  
  
  CONCLUSIONS
  This study provides new information about the clinical utilization of instrument-assisted prosthetic alignment techniques for individuals with transtibial amputation.
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Caroline Wen Jia
authors.initials: CW
authors.lastname: Chen
authors.affiliation: Sunnybrook Centre for Independent Living, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Winfried
authors.initials: W
authors.lastname: Heim
authors.affiliation: Sunnybrook Centre for Independent Living, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Fairley
authors.affiliation: Sunnybrook Centre for Independent Living, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Clement
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Elaine
authors.initials: E
authors.lastname: Biddiss
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Torres-Moreno
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada jan.andrysek@utoronto.ca.
authors.forename: Jan
authors.initials: J
authors.lastname: Andrysek
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001186:Artificial Limbs; D018592:Cross-Over Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D016059:Range of Motion, Articular / Q000502:physiology; D013977:Tibia; D055815:Young Adult
keywords: Testing of prosthetic and orthotic components; biomechanics of prosthetic/orthotic devices; gait analysis; prosthetic alignment; rehabilitation of prostheses users; transtibial amputation